摘要:

AbstractThe importance is emphasized of the inadequacy of the term “body temperature”, but that both core temperature and the peripheral temperature must be considered. The assessment of vasoconstriction is informative, and advantage should be taken of the exact information that can be provided by an electro‐thermometer as opposed, for example, to a touch of the hand. The core temperature is taken from the rectum, the nasopharynx or tympanic membrane, and the peripheral temperature from the great toe.If the peripheral temperature falls the loss of body heat is prevented and the core temperature rises. If this is not understood or not recognized misguided attempts may be made to try to reduce the raised central temperature by cooling the skin. This can result in a further rise of central temperature. The recognition of peripheral vasoconstriction enables a proper assessment to be made of its basic cause and of the necessary treatment.The most important cause is hypovolaemia from blood loss and a detailed account is given of how this should be recognized, especially by a study of the gradient between central and peripheral temperatures. Such studies should be a routine in any severe illness, whether medical or surgical, in which circulatory deterioration is likely, especially after major operations or injuries.Study of the temperature of the heel (hindfoot) as well as of the toe (forefoot) can indicate a selective shutdown of peripheral circulation that reveals an especially critical circulatory

ISSN:0007-1323    

DOI:10.1002/bjs.1800620802

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractWe have used the extraperitoneal approach for aortoiliac reconstruction for lower limb ischaemia in over 130 patients. The operative exposure is excellent. Operating time is shortened and the upset to the patient much less than in the transperitoneal approach. We now believe that the method is suitable for use in the majority of aorto‐iliac reconstructions. Patency rate 4 years after surgery for claudication is 89 per cen

ISSN:0007-1323    

DOI:10.1002/bjs.1800620803

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractTen patients with carcinoma of the lower third of the oesophagus who had oesophagogastrectomy followed by oesophagogastrostomy without a drainage procedure were investigated 6 months postoperatively. Postoperative symptomatic evaluation and modified Visick grading of the results were carried out by an independent observer. Objective assessment included fibre‐optic endoscopy of the oesophagus, stomach and duodenum, gastric acid secretory studies and measurement of gastric emptying times following the ingestion of a barium food mixture.Eight of the 10 patients had an excellent or very good result and the remaining 2 were graded as satisfactory. No evidence of macroscopic oesophagitis or gastritis was detected and pyloric obstruction was never observed. Gastric emptying time was not prolonged. The results obtained support the concept that a drainage procedure is unnecessary after oesophagogastrostom

ISSN:0007-1323    

DOI:10.1002/bjs.1800620804

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA series of 8 patients with severe oesophageal strictures secondary to reflux oesophagitis who have been treated by antrectomy with Roux‐en‐ Y anastomosis is described. There was 1 postoperative death. The remaining patients have been completely relieved of heartburn and all have had a dramatic improvement in their dysphagia. This method of treatment is strongly recommended for patients who have had prior surgery to the hiatus which has failed, and for those who are too elderly or frail to withstand a direct attack on their oesophageal strict

ISSN:0007-1323    

DOI:10.1002/bjs.1800620805

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe clinical results of gastric mucosal resection are reported after a 1–10‐year follow‐up in which 76 per cent of patients were followed up for more than 5 years. There were 3 postoperative deaths in 152 patients. Mucosal antrectomy with vagotomy for duodenal ulcer in 96 patients, and for recurrent ulcer in 9 patients, has not been followed by a single recurrence. Gastric mucosal resection alone for the treatment of gastric ulcer in 21 patients resulted in 1 recurrence.Although vagotomy combined with resection is currently out of fashion for the initial treatment of duodenal ulcer in Britain, mucosal gastric resection has technical advantages in combination with vagotomy for the cure of recurrent ulcers following duodenal ulcer su

ISSN:0007-1323    

DOI:10.1002/bjs.1800620806

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractMaterial obtained from 35 cases of abdominal tuberculosis was studied and an attempt was made to demonstrate tubercle bacilli by special staining of histological sections, culture and guinea‐pig inoculation.Acid fast bacilli could be demonstrated in 80 per cent of cases. The remaining cases were also possibly due to tuberculous infection because granulomas with Langhans's type of giant cells and caseation or calcification of lymph nodes were present. The bacilli were demonstrated in bowel tissue showing non‐specific histology in 1 case. In 2 other cases with non‐specific lesions in the bowel the bacilli were demonstrated in lymph nodes.Guinea‐pig inoculation studies showed that hypertrophic lesions of the bowel with a non‐specific type of reaction could develop after intraperitoneal injection of tubercular material.Although it cannot be said on the basis of this study that Crohn's disease is caused by tuberculous infection, it can be concluded that tuberculous infection can give rise to a Crohn's type

ISSN:0007-1323    

DOI:10.1002/bjs.1800620807

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractA case of primary gastric tuberculosis is reported in a 34‐year‐old Negro male. The difficulty in diagnosis is emphasized. Surgical resection with postoperative anti‐tuberculosis chemotherapy was followed by satisfactory rec

ISSN:0007-1323    

DOI:10.1002/bjs.1800620808

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractFive cases of congenital hepatic fibrosis are described. In all the patients the diagnosis was delayed as a result of either failure to perform liver biopsy or misinterpretation of the histological features. Four patients had multiple operations for the control of haematemesis or the relief of portal hypertension. It is stressed that a high index of suspicion, the use of endoscopy and a liver biopsy are essential to avoid delay in diagnosis. The patients have a good prognosis provided that the diagnosis is established at an early stage and portacaval anastomosis performed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620809

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractVarious aspects of splenic‐gonadal fusion are discussed and 1 case of the continuous type is reported. A plea is made to include this condition in the differential diagnosis of scrotal masses, particularly those on the left sid

ISSN:0007-1323    

DOI:10.1002/bjs.1800620810

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY

摘要:

AbstractThe number of cases of abdominoscrotal hydrocele reported in the literature has been brought up to date, which, including the 3 cases reported here, is 83 of which 21 are from India.The pathogenesis of this lesion is discussed. It is concluded that all cases of abdominoscrotal hydrocele are due to progressive involvement and distension of the patent processus vaginalis which is cut off from the general peritoneal cavity.A new classification of abdominoscrotal hydrocele is suggested on the basis of experience gained from the 3 cases reported here.

ISSN:0007-1323    

DOI:10.1002/bjs.1800620811

出版商:John Wiley&Sons, Ltd.    

年代:1975

数据来源: WILEY