摘要:

AbstractThe management of 93 patients with craniocerebral gunshot wounds is reviewed. The contrast between the injuries of urban guerilla warfare, conventional warfare and civilian life is outlined. Emphasis is placed on the need for early and adequate transfusion and for immediate airway control to limit cerebral oedema. Principles of wound surgery evolved in other conflicts were followed and developed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610302

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractAlthough Trasylol has been available for the treatment of acute pancreatitis for 15 years a review of the literature reveals that its effectiveness has never been either proved or disproved. A prospective double blind controlled trial was therefore started in 1967. The results are now reported.One hundred and five patients were studied. They provided a uniform clinical material and all were managed on an identical strict protocol except that patients received either Trasylol A or B, allotted in sequence using random numbers. At the conclusion of the acute episode the illness was assessed according to criteria which were not open to observer variation and each attack was categorized as mild, moderate, severe or fatal. The trial showed that there was a mortality of 4 out of 53 cases (7.5 per cent) in group A and 13 out of 52 cases (25 per cent) in group B. Statistically this difference is significant (χ2= 4.675, d.f. = 1, P = 0.05). The code was then broken and this revealed that group A had received the active Trasylol. Analysis of age patterns showed that in the Trasylol‐treated group the usual tendency for mortality to rise with advancing age was abolished. Trasylol must therefore be regarded as a drug which is beneficial in the treatment of acute pancreatit

ISSN:0007-1323    

DOI:10.1002/bjs.1800610303

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractDeleterious effects of elevated free fatty acids have been demonstrated in both diabetic and non‐diabetic patients. Recent studies have shown drastic and prolonged elevations of free fatty acids following heparin injection in postoperative diabetic patients. This study demonstrated no significant difference in response of two groups of preoperative diabetics maintained on either insulin or oral hypoglycaemic agents, but it has revealed that individual diabetics who respond to heparin with a massive elevation of free fatty acids can be easily identified with a simple preoperative injection of 5000 units of intravenous hepari

ISSN:0007-1323    

DOI:10.1002/bjs.1800610304

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractDuring routine studies of oesophageal motility the lowest pH recorded from the stomach has been measured by a stomach electrode on 263 separate occasions.The mean pH of 117 male patients with duodenal ulceration was 1.3 ± 0.3 (mean±1 standard deviation), and this was lower than in 17 patients with a gastric ulcer (1.7 ± 0.3) and 19 with a hiatal hernia (1.6 ± 0.4). Patients with a gastric ulcer had a lower pH than those with gastric carcinoma (2.3 ± 0.9).The lowest pH of duodenal ulcer patients was changed by truncal vagotomy (37 patients) to 1.3 ± 0.8 and by a Polya partial gastrectomy (25 patients) to 3.2 ± 1.8.If a stoma1 ulcer was present after a partial gastrectomy the pH was 1.1 and this changed to above 1.9 after va

ISSN:0007-1323    

DOI:10.1002/bjs.1800610305

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractTotal body water and total exchangeable sodium were measured in 29 patients who had undergone subtotal colectomy with ileorectal anastomosis for chronic ulcerative colitis more than I year previously and in a control group of 28 normal persons. Significant dehydration and sodium depletion in the patients were not demonstrated when compared with the controls. These findings are in contrast to the dehydration and sodium depletion previously demonstrated in ileostomy patients. Faecal loss of sodium in patients with ileorectal anastomosis was found to be less than in patients with ileostomies. The findings suggest that ileorectal anastomosis carries less risk of long‐term, fluid and electrolyte depletion than ileostom

ISSN:0007-1323    

DOI:10.1002/bjs.1800610306

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThe results of surgical treatment of 81 cases of reflux oesophagitis during the period 1958–70 are reported.From 1958 to 1966 a simple repair, i.e. repair of the hiatus and reconstruction of the oesophagogastric angle, was done. From 1966 to 1970 a fundoplication was substituted. About half of the cases with simple repairs also had vagotomy and pyloroplasty, and some had cholecystectomy for associated gallstones.Of the entire series, 92 per cent had a good clinical result and 78 per cent were good radiologically. Comparing simple repair with fundoplication, 92 per cent of the cases in both groups were good clinically, but radiologically 97 per cent of the fundoplications were good compared with 60 per cent of the simple repairs.Two of 44 simple repairs have required further surgery for recurrent oesophagitis. There has been no recurrent oesophagitis in the fundoplication group, but dysphagia has been a problem requiring reoperation in I case and repeated bouginage in 3 others. Postprandial discomfort due to dificulty in belching occurs. Vagotomy has not had a beneficial effect, the group without vagotomy being superior both clinically and radiologically.To conclude, simple repair by the abdominal route has given good clinical results in 92 per cent of 44 patients followed for 6–12 years. Neither fundoplication nor vagotomy has improved these results and both can add complicati

ISSN:0007-1323    

DOI:10.1002/bjs.1800610307

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThirty‐six patients who had undergone a simple repair of a hiatus hernia were examined with regard to the postoperative symptomatology, persistence of reflux as judged by radiological means and the pressures of the lower oesophageal sphincter. One‐third of these patients had persistent symptoms although these were usually mild. It has not been possible to correlate the persistence of symptoms with either the demonstration of radiological reflux or reduced lower oesophageal sphincteric pressu

ISSN:0007-1323    

DOI:10.1002/bjs.1800610308

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA retrospective comparison of latex and silicone rubber T‐tubes draining the common bile duct in the Rhesus monkey shows that both tubes excite an adequate local tissue reaction. However, latex rubber degenerated more rapidly than silicone rubber, the interval between insertion of the tube and onset of complications being significantly shorter (7.2 ± 0.9 (s.e.) weeks against 17.6 ±6.2 weeks).It is suggested that silicone rubber T‐tubes have a place in human biliary surgery, especially when long‐term drainage of the biliary tract is re

ISSN:0007-1323    

DOI:10.1002/bjs.1800610309

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA study of 26 cases of advanced carcinoma of the tongue treated by radical total glossectomy is presented. The selection of cases, the operative technique and the postoperative management are described. As seen from the follow‐up of this series this procedure is able to effect a cure in some cases and give good palliation in the majority of cases of localized advanced carcinoma of the tongue. None of our patients needed postoperative laryngectomy for the complication of aspiration pneumoni

ISSN:0007-1323    

DOI:10.1002/bjs.1800610310

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThe changes in blood fibrinolytic activity, measured by an isotopic method, have been studied in 50 patients following a major surgical operation.A phase of enhanced fibrinolytic activity occurred at the time of operation. Subsequently no evidence of prolonged depression of fibrinolytic activity was demonstrated.Patients who developed postoperative deep vein thrombosis, as diagnosed by the125I fibrinogen technique, exhibited significantly lower fibrinolytic activity on the first postoperative day than patients with no thrombosis (P<0.01); apart from this the two groups of patients showed no demonstrable difference in fibrinolytic activity in the 7 days after operation.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610311

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY