ISSN:0007-1323    

DOI:10.1002/bjs.1800751102

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800751103

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractIn a randomized prospective trial, the efficacy of low molecular weight heparin (LMWH) (Fragmin®) and dextran 70 (Macrodex®) in preventing deep vein thrombosis (DVT) in the legs was evaluated in 98 consecutive patients undergoing elective total hip replacement. The patients were randomly allocated to receive either 2500 anti‐factor Xa units LMWH twice daily for 7 days, with the first dose given 2 h before surgery; or 500 ml dextran 70 twice during the day of operation, followed by a single infusion of 500 ml on the first and again on the third postoperative day. DVT was assessed by125I‐fibrinogen test for 2 weeks postoperatively, a positive test being followed by phlebography. DVT developed in 22 (45 per cent) of 49 patients receiving dextran 70 and in 10 (20 per cent) of 49 patients in the LMWH group (P<0.01). LMWH was thus statistically significantly better than dextran 70 in preventing DVT in the legs. It was not firmly established whether this benefit was also valid in the high ileofemoral region. Two patients with non‐fatal pulmonary embolism were found in each group. Per‐ and postoperative blood loss and blood transfusion requirements were significantly lower in the L

ISSN:0007-1323    

DOI:10.1002/bjs.1800751104

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractIn a prospective, randomized multicentre trial the efficacy and safety of the low molecular weight heparin (LMWH) fraction Fraxiparin® and unfractionated calcium heparin (Calciparin®) were compared for the prevention of postoperative deep vein thrombosis. Of 1909 patients included in the trial 1896 underwent abdominal surgery and received either one daily subcutaneous injection of 7500 anti‐X a units Fraxiparin or 5000 units calcium heparin three times a day subcutaneously. Elastic compression stockings were worn by both groups of patients in the postoperative period. Before randomization the patients were stratified in two subgroups with or without malignant disease. To assess the rate of deep vein thrombosis (DVT),125I‐labelled fibrinogen leg scanning was performed daily for 7 postoperative days. Positive results were confirmed by phlebography whenever possible. Venous thrombosis occurred in 27 of 960 patients (2.8 per cent) given Fraxiparin and in 42 of 936 patients (4.5 per cent) given calcium heparin (P = 0.034). The rates of proximal vein thrombosis were 0.4 per cent (4 patients) and 1.4 per cent (13 patients) respectively (P<0.05). Pulmonary embolism occurred in 2 of 960 patients (0.2 per cent) treated with Fraxiparin and in 5 of 936 patients (0.5 per cent) treated with calcium heparin. The two treatments were equally well tolerated. Intra‐ and postoperative blood loss, the number of wound haematomas as well as frequency and volume of transfusions were similar in both groups. The present trial demonstrates that a single daily subcutaneous injection of Fraxiparin is more effective than the established low dose subcutaneous heparin prophylaxis with 5000 units three times per day in preventing postoperative DVT after abdominal surgery in patients wearing compression st

ISSN:0007-1323    

DOI:10.1002/bjs.1800751105

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractAlthough femorofemoral bypass grafting was originally used only as a method of limb salvage, it is now used increasingly in patients with claudication. If this trend is to be supported, the haemodynamic consequences of the operation must be carefully assessed. Fifteen patients undergoing femorofemoral grafting were studied prospectively by intra‐operative measurement of the inflow resistance (IR) of the donor iliac segment. Three groups were identified by this technique. Patients with an IR<0.05 (n = 8) were uncomplicated; those with an IR ⩾0.05 but0.10 (n = 2) developed a clinical steal syndrome. High initial IR values were corrected at the time of surgery in two cases. This study demonstrates that steal syndromes can occur after femorofemoral grafting and that the cause is an unmasking of previously unrecognized disease in the donor arterial segment. The measurement of IR allows the prediction of steal syndromes and their correction at the time of surgery. Direct haemodynamic studies are recommended, especially as the availability of balloon angioplasty has made inflow disease amenable to treatm

ISSN:0007-1323    

DOI:10.1002/bjs.1800751106

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractMonoclonal antibody technology has been an important development in breast cancer research. Monoclonal antibodies do not detect ‘breast cancer specific’ antigens but, rather, they react with normal or modified tissue antigens which are either preferentially or inappropriately expressed upon malignant cells. Thus far a number of monoclonal antibodies that have a preferential reaction with breast cancer tissue have been developed. They have a potential value in immunohisto‐pathology as diagnostic tools and in the recognition of small quantities of malignant cells, in the development of serum assay for tumour markers in breast cancer and in the radio‐immunodetection of metastases. There has been success in effecting selective targeting of anticancer agents (cytotoxic drugs, toxins, radionuclides) to tumour deposits and encouraging results are obtained in preclinical in vivo studies. Various clinical studies are now in progress to evaluate the role of monoclonal antibodies in the management of breast

ISSN:0007-1323    

DOI:10.1002/bjs.1800751107

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800751108

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractA case control study has been conducted to determine the value of stearic/oleic acid ratios in the erythrocyte membranes of women at the time of presentation with breast cancer. No difference was found between the stearic/oleic acid ratio of cases and that of controls with benign breast condition or normal volunteers. Furthermore, within clinical stages of breast cancer, no differences were detected. This ratio does not appear to be of value as a marker of malignancy, or of tumour burden.

ISSN:0007-1323    

DOI:10.1002/bjs.1800751109

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractA prospective study of 112 patients with clinically discrete benign breast lumps has shown that 68 per cent of patients experienced resolution of their lumps over a period of up to 2 years. Resolution of both fibro‐adenomas and discrete areas of fibro‐adenosis was observed. Diagnosis was achieved by clinical examination and fine needle aspiration cytology. Four patients thought clinically to have benign disease were proven by cytology to have a carcinoma, but no patient with a cytopathological diagnosis of benign disease has developed cancer during or subsequent to this study. We recommend that patients under 35 years of age with clinically and cytologically benign breast lumps can be offered the option of non‐excision in the reasonable expectation of resolution of their l

ISSN:0007-1323    

DOI:10.1002/bjs.1800751110

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY

摘要:

AbstractTemperature difference between the rectum and anal canal is a fundamental requirement for the hypothesis that temperature sensation is of physiological importance in discrimination of anorectal contents occurring during the ‘sampling reflex’. The temperature gradient between the rectum and the anal canal was measured in 47 normal subjects (mean age 51.6 years ± 16.8 s.d., 24 men). The maximum mean difference in temperature between the rectum and the anal canal was 0.13°C (0.06‐0.19, 95 per cent confidence intervals) and occurred 4 cm from the anal verge. This difference is too small to be detected by the anal canal mucosa. Under normal physiological circumstances the conscious appreciation of temperature of faeces passing from the rectum to the anal canal is impossible during the anorectal sampling

ISSN:0007-1323    

DOI:10.1002/bjs.1800751111

出版商:John Wiley&Sons, Ltd.    

年代:1988

数据来源: WILEY