ISSN:0007-1323    

DOI:10.1002/bjs.1800720302

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractThe main problem facing patients with ulcerative colitis after mucosal proctectomy and ileo‐anal anastomosis (MP + IAA) is severe frequency of bowel action. Although the addition of a pelvic reservoir can improve matters, some patients still complain of this problem. In an attempt to slow transit, enhance absorption and improve function, we investigated the effects on these parameters of (1) a reversed ileal segment, (2) an artificial valve in an animal model. Studies were conducted before and after operation. The dogs randomly underwent either colectomy and low ileorectal anastomosis (IRA) alone (control, n = 12), IRA with a 10 cm reversed loop (IRA + RL, n = 10) or IRA with an artificial valve (IRA + valve, n = 10). Operative mortality rates were similar in the groups. Mean transit time (MTT) was significantly reduced after the control operation and after IRA + RL but not after IRA + valve. In addition MTT after IRA + valve (21±s.d., 3.4 h) was significantly greater than in the other two groups (control = 12.1 ± 4.3 h, IRA + RL, 12.8±5.5 h, P<0.04) and frequency of bowel actions seemed less. Measurements of absorption and nutritional state, however, did not differ significantly between the groups. Thus, although the artificial valve made no difference to absorption, it did prevent the reduction in MTT that occurred after the control operation whereas the reversed loop did not. This effect might thus benefit patients who undergo MP +

ISSN:0007-1323    

DOI:10.1002/bjs.1800720303

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractA stapling device has been used to disconnect the lesser curve of the stomach during highly selective vagotomy in a consecutive series of ten patients. This modification renders the operation technically easier and quicker to perform. Postoperative recovery was uneventful in all patients, and in the subsequent follow‐up period of 7–15 months, no problems relating to the technique were encounte

ISSN:0007-1323    

DOI:10.1002/bjs.1800720304

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractFifty‐seven patients, with chronic duodenal ulceration resistant to cimetidine therapy, underwent proximal gastric vagotomy during the period August 1979 to May 1984. Thirty‐five failed to respond to cimetidine in a dose of 1 g/day, whilst 22 relapsed on reduction of dosage to 400 mg daily or on cessation of therapy. Forty have been followed up for a period of 12–53 months (median duration = 28.5 months), and assessed using the modified Visick system. Thirty‐four patients (85 per cent) were graded Visick I or II. Four patients (10 per cent) had non‐specific upper gastrointestinal symptoms (Visick III). In these patients endoscopy has shown no evidence of recurrent ulceration. Two patients (5 per cent) were graded Visick IV. One had recurrent ulceration on endoscopy. The other developed symptomatic gastro‐oesophageal reflux, necessitating further surgery. These results support the view that cimetidine resistance is not a predictor of poor results following proximal gastr

ISSN:0007-1323    

DOI:10.1002/bjs.1800720305

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800720306

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractFifty‐five patients presenting with acute abdominal symptoms and found to be hyperamylasaemic underwent early biliary tract investigation, giving 31 patients in whom the presence of gallstones was suspected. In accordance with the protocol of a randomized controlled trial of early elective biliary tract surgery for patients suspected of having acute gallstone pancreatitis, 19 of these patients underwent laparotomy at a mean of 6.9 days after emergency admission. In this group operation showed that four patients had biliary tract stones and pancreatitis; ten patients had calculous cholecystitis (53 per cent) but no stigmata of pancreatitis; four patients had pancreatitis but no stones; one had a negative laparotomy. None of this group was found to have ampullary obstruction due to an impacted stone. Biliary tract investigations carried out during the first week following admission were unhelpful or misleading in 14 out of the whole group of 55 patients, and in all of those patients (11 per cent) who died or required surgical intervention during the same hospital admission. There appears to be a pathological heterogeneity among patients diagnosed as ‘gallstone pancreatitis’ on clinical and biochemical grounds

ISSN:0007-1323    

DOI:10.1002/bjs.1800720307

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractA randomized controlled trial of the value of oral adjuvant cytotoxic chemotherapy in the treatment of potentially curable breast cancer has been in progress in the Oxford Region since 1977. Eighty‐seven patients were allocated to treatment with melphalan 0.2 mg/kg for 5 consecutive days every 6 weeks for 2 years; 98 patients were allocated to treatment with oral combination therapy consisting of melphalan 10 mg daily for 5 consecutive days, plus methotrexate 15 mg and 5‐fluorouracil 250 mg on the first day, courses being repeated every 6 weeks for 2 years; and 88 patients were allocated to a control group which received no adjuvant chemotherapy. So far, 125 patients have suffered a recurrence of breast cancer and 85 have died. No statistically significant differences in outcome are apparent between the three treatment groups, although there is some indication of a beneficial effect of chemotherapy on disease‐free interval in pre‐menopausal women. Toxic effects of treatment, notably nausea, vomiting and bone marrow depression, have been moderately severe. In our view, the beneficial effects of current adjuvant cytotoxic chemotherapy, if any, are too modest to justify the suffering which such treatment can cause at a time when a woman with breast cancer might otherwise expect to feel physical

ISSN:0007-1323    

DOI:10.1002/bjs.1800720308

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractEpidermal growth factor (EGF) is a potent mitogen for many tissues including breast. The receptor for EGF (EGF‐r) has the same peptide sequence as a known oncogene. Sixty‐one human breast cancers and nine associated lymph node metastases have been examined for the presence of EGF receptors by competitive binding and immunocytochemical techniques. Oestrogen receptor analysis on the same specimens was performed by the dextran coated charcoal method and compared with EGF‐r status. These were correlated with the clinical findings and histological data. An inverse relationship between EGF‐r and ER was found (χ2= 7.81, P<0.01) with a higher incidence of EGF‐r positive tumours in the metastatic group (χ2= 14.51, P<0.001). EGF‐r positive tumours were of poor differentiation and had characteristics associated with p

ISSN:0007-1323    

DOI:10.1002/bjs.1800720309

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

ISSN:0007-1323    

DOI:10.1002/bjs.1800720310

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY

摘要:

AbstractAll breast cysts aspirated from a series of 100 patients followed for a minimum period of 2 years were classified on the basis of electrolyte composition as apocrine or flattened, this being the nature of the epithelium lining the two populations of breast cysts. Patients with single cyst were more than 3 times as likely to have a flattened rather than an apocrine cyst. Multiple cysts, whether simultaneous or sequential in any individual patient, were usually all of the same type, and were more commonly apocrine than flattened. A comparison of the frequency of subsequent cysts in patients whose initial cysts were of eithere apocrine than flattened. A comparison of the frequency of subsequent cysts in patients whose initial cysts were of either apocrine or flattened type showed further cysts were over 5 times more common in patients who presented with apocrine cysts. These observations suggest that the natural history of cystic disease is closely related to cyst type.

ISSN:0007-1323    

DOI:10.1002/bjs.1800720311

出版商:John Wiley&Sons, Ltd.    

年代:1985

数据来源: WILEY