摘要:

AbstractGastro‐oedophageal reflux may be responsible for symptoms and sometimes for the development of oesophageal damage. These effects are inconstant when reflux is demonstrated by radiography or by conuentional pH studies. This unpredictability may be accounted for by the observation that during the day refluxed material is rapidly cleared from the oesophagus by swallowing, while during sleep little swallowing occurs. To explore the hypothesis that reflux during deep is the important factor, prolongedintra‐oesophageal pH studies have been done and a method has been developed for quantifying nocturnal gastro‐oesophageal reflux11.The investigation has Ahown that persistence of acid within the oesophagus is associated with prolonged periods during sleep when no swallowing occurs. Measurements of nocturnal intra‐oesophageal pH were made in 41 patients with symptomatic sliding hiatus hernia. In 12 patients with mild symptoms reflux measured by this index did not exceed 15 minutes, with one exception, and no patient showed oesophagitis. In 10 patients with moderate symptoms reflux did not exceed 1 hour, with one exception, and mild to moderate oesophagitis was present in 4 cases. Nineteen patients had severe symptoms; in all hut one the period of reflux was in excess of 1 hour, and oesophagitis was foun

ISSN:0007-1323    

DOI:10.1002/bjs.1800610402

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA new technique is described for the experimental production of gastric ulcers in dogs. It depends on producing an intermittent but severe localized increase in the contractility of the stomach by means of electrodes implanted in the gastric muscle. A suitable stimulator is attached to the animal's back. Following some early technical, failures an adequate stimulus was applied for 2–3 weeks in 16 animals. In 13 cases macroscopic lesions developed in the stimulated area, varying from frank perforation to superficial erosions. Confirmation by barium meal examinations and histology is provided.It is suggested that the responsible mechanism may be a localized ischaemia, due to the increased muscle spasm, predisposing to the necrosis and ulceration of the mucosa followed by the more superficial layers of the stomach wal

ISSN:0007-1323    

DOI:10.1002/bjs.1800610403

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractFrom July, 1964, to July, 1968, bilateral selective vagotomy and pyloroplasty were performed in 135 patients for duodenal ulcer, without postoperative mortality. Two unrelated deaths occurred during the period of the survey and 2 other patients were lost to follow‐up. The remaining 131 patients were followed up for a minimum of 5 years and a maximum of 9 years.The most frequent symptoms were epigastric fullness, early dumping and mild diarrhoea. Only I case of moderate diarrhoea was observed, and none of severe diarrhoea. Food vomiting, bile vomiting and hypo‐glycaemia‐like attacks were uncommon. Recurrent duodenal ulcer was proved in 4.6 per cent and highly suspected in 1.5 per cent. Gastric ulcer was proved in 3‐1 per cent. Approximately 91 per cent of the patients were classed as having a satisfactory result and 9 per cent were unsatisfactory.It is concluded that bilateral selective vagotomy is clearly effective in controlling the ulcer diathesis in the long term. In addition, it seems to lessen some of the side‐effects of gastric surgery. For these reasons, consideration should be given to its use in the surgical treatment of duode

ISSN:0007-1323    

DOI:10.1002/bjs.1800610404

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThe place of the trace element zinc in wound healing has been the subject of much recent discussion. Since it is theoretically possible that seriously ill surgical patients may become zinc deficient it seems of importance to establish the relationship between zinc and wound healing. In the experiments described here zinc deficiency has been created in rats and two parameters of wound healing, namely the rate of epithelialization of excised wounds and the development of tensile strength in incised wounds, have been measured and compared with similar measurements in control animals. It has been shown that there was a significant delay in the healing of excised wounds in zinc‐deficient animals, and the development of tensile strength in incised wounds was also significantly less when measured at the same time as the wounds of control animals. Histologically there was no difference in the wounds of zinc‐deficient or control anim

ISSN:0007-1323    

DOI:10.1002/bjs.1800610405

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

Abstract1Observations have been made by light and electron microscopy of the development of peritoneal adhesions in the rat following abdominal surgery.2Essentially the changes which occurred were those which are seen in healing by fibrosis, except that in many areas of adhesions numerous eosinophils were observed by electron microscopy. In areas where eosinophils were numerous little proliferation of fibro‐blasts was seen. Conversely in sites where fibroplasia and collagen formation were well advanced no eosinophils were seen.3The role of the eosinophil in the development of adhesions is discussed and it is suggested that the presence of eosinophiis with their associated anti‐histamine activity may hold in check the proliferation of fibroblasts while a new mesothelium is formed and thus prevent adhesion format

ISSN:0007-1323    

DOI:10.1002/bjs.1800610406

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA study at the Reading District Hospitals on 451 consecutive patients undergoing appendicectomy through grid‐iron incisions sought to determine factors influencing wound infection and the effects of a prophylactic wound‐spraying procedure. Wound infection increased with the severity of appendicular inflammation and was well correlated with the degree and nature of bacterial contamination at the time of wound closure1.The infection rate was reduced by about one‐half when either an aerosol dry‐powder formulation of povidone iodine (Disadine D. P.1) or an aerosol antibiotic powder spray containing neomycin, bacitracin and polymixin (Dispray) was sprayed on the wound before and after closure. The reduction of infection achieved by spraying with pouidine iodine was statistically significant (P<0.025). The results of the polyantibiotic spraying did not quite reach significance (P<0.06)1.The povidone iodine dry powder was better overall since it reduced infection in all degrees of appendicular inflammation, in all age groups and in enlarged, drained, contaminated and non‐contaminated wounds without the attendant disadvantages of an

ISSN:0007-1323    

DOI:10.1002/bjs.1800610407

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractIn a general surgical unit, during a 6‐year period between June, 1967, and May, 1973, anaerobic bacteriaemia was noted in 23 patients, of whom 4 had Gram‐positive clostridial bacteriaemia. Nineteen patients had Gram‐negative Bacteroides species in their blood. In these patients the infection appeared to have come from bacteria that were normal commensals of the patients' gastro‐intestinal tracts. The use of antibiotics to which Bacteroides species were resistant may have suppressed more invasive bacteria, allowing the selective proliferation of bact

ISSN:0007-1323    

DOI:10.1002/bjs.1800610408

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractAn unusual presentation of Crohn's disease is reported. Massive rectal haemorrhage threatening the life of the patient resulted in emergency right hemicolectomy. No further bleeding has since occurred.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610409

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThe association of diverticulitis and acute ulcerative colitis is uncommon but carries a high mortality. Four cases are described with diverticular disease who developed fulminating ulcerative colitis. The double diagnosis was not initially recognized in any of these cases and in 2 the diagnosis of ulcerative colitis was only made at laparotomy.Three of the 4 patients died following surgical treatment and the difficulties of their diagnosis and management are discussed. It is suggested that sigmoidoscopic examination before emergency bowel surgery is important.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610410

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractMeasurements made on cadavers showed that the facial nerve is usually less than a centimetre from the classic line of transection used in a radical neck dissection. The use of the transverse process of CI as a landmark is presented as a reliable method of avoiding a facial nerve paralysis in the operation.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610411

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY