摘要:

One hundred and forty‐seven colostomies were closed in 146 patients at wellington hospital between i january 1978 and 1 january 1987. The majority of stomata were formed in patients with colorectal cancer. At least one additional significant procedure was undertaken at the time of stoma closure in 10 patients. The overall complication rate was highest in those patients undergoing closure of a sigmoid end‐colostomy (50%). Three complications resulted in death (2%). Twenty‐four patients (16.3%) developed wound infections. Five patients developed ‘leaks’ (3.4%). The use of prophylactic antibiotics appeared to reduce the rate of infection significantly. The highest rates of wound infection and leakage occurred in patients in whom drains were used. Wound infections increased hospital stay. Thirty‐one non‐bowel or wound‐related complications occurred

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01465.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A series of 14 vein‐to‐artery grafts, 1 mm in diameter and 5 mm long, were inserted microsurgically into iliac arteries of rats. They were analysed histologically 8–18 months later and compared with control iliac arteries in the same rats.Neo‐intimal hyperplasia developed and was measured in all grafts but the values did not significantly exceed the equivalent intimal plus medial thicknesses of control arteries. Vasa vasorum developed and were quantitated as the number of vessels per mm2of neo‐intima, but also did not differ significantly from control values. The density of sympathetic innervation was quantitated using fluorescent catecholamines. There was an overall significant increase in the long‐term graft innervation compared with control arteries.These results show that such small vein grafts adapt and function very effectively, in a manner remarkably similar to the artery they replace, for long peri

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01466.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Autotransfusion of operatively salvaged blood is an increasingly attractive and used practice. The fear of precipitating a coagulopathy, however, has retarded the acceptance of autotransfusions and the efficiency and convenience of banked homologous blood has proved too competitive in recent years. The risk of transmitting diseases with bank homologous blood has seen a resurgence in the development of autotransfusion. The current alternatives to pre‐operative autologous banking or dilution are the reinfusing of filtered salvaged blood, and of blood which has been further processed by washing which involves the extra cost of time, personnel and equipment. Washing removes possible harmful products, but also removes coagulation factors.D‐dimer levels were estimated by monoclonal antibody techniques in salvaged blood before and after washing in 10 patients undergoing aortic surgery and in 10u of homologous banked blood. The d‐dimer levels in the unwashed blood were increased 85 times, but were normal in the washed blood. D‐dimers are an indication of activation of the coagulation and fibrinolytic systems and the presence of fibrin degradation p

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01467.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

The evolution of the procedures for the formation of a surgical abdominal stoma are outlined; this was first, intestinal exteriorization for trauma, then stoma formation alone and finally stoma formation associated with bowel resection. Accounts and recommendations occurred in the 16th and 17th centuries as by pillore and duret, but were few in number. Development of the stoma on a sound basis did not occur until the late 19th century. Dupuytren, bryant, maydl, mikulicz von radecki and miles were prominent in this development.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01468.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

A rare case of pre b‐lymphoblastic lymphoma of the testes and adrenal glands is presented. No lymph node, central nervous system or bone marrow involvement was demonstrated at diagnosis. The primary presentation was of acute unilateral pain and swelling, mimicking simple orchitis. The diagnosis was made using aspiration cytology and the lymphoma characterized using immunohistochemical, electron microscopic and karyotype analysis techniques.Pre b‐cell markers were clearly demonstrated by all criteria used. Monoclonal antibodies (fmc 29 and fmc 31) were used to define the early b‐cell nature of the lymphoma. Confirmation using karyotype analysis in addition to immunoglobulin and t‐cell β‐receptor gene rearrangement was obtained.Intrathecal chemotherapy was used prophylactically. Combination chemotherapy produced regression of the primary lymphomatous lesions, but subsequent bone marrow spread le

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01469.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Two cases of chronic adhesive spinal arachnoiditis following documented subarachnoid haemorrhage (sah) are reported. Both cases progressed to severe spinal cord dysfunction with paraplegia. It is hoped that this case report will highlight this uncommon but extremely disabling complication of sah.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01470.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Hydrofluoric acid is a strong inorganic acid. It is used commercially in a number of industrial settings. Injuries sustained from this acid are infrequent and the management of such cases is therefore not well known. Tissue destruction caused by this acid is rapid and severely painful and may result in disfigurement if treatment is not instituted promptly. Methods of management of hydrofluoric acid bums are still controversial and no single type of therapy has yet been determined. The patient was managed according to the guidelines in the literature, but, in the presence of severe digital oedema, intra‐arterial infusion of calcium gluconate was performed. This resulted in rapid relief of pain and prevention of continuing tissue destructio

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01471.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Kienböcks disease is an uncommon condition occurring in adults but rarely in children. A case occurring in an 8 year old boy is presented. This patient showed a strongly negative ulnar variant, which may have been an aetiological factor in his young presentation

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01472.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

摘要:

Book reviewed in this article:COLOUR ATLAS OF PARATHYROID EXPLORATION: By Andrewgunn.TRAUMA, SEPSIS AND SHOCK: THE PHYSIOLOGICAL BASIS OF THERAPY: edited by H. A. ClowesJr.THE HEART OF A SURGEON: THE MEMOIRS OF HARRY WINDSOR. By HarryWindsorFRCS, FRACS.RECENT DEVELOPMENTS IN ORTHOPAEDIC SURGERY. Edited by J. Noble andC. S. B. Galasko.1987 YEAR BOOK OF SURGERY. Edited by S. I. SchwartzMD, O. JonassonMD. E. E PeacockJrMD, G. T. Shires, F. C. SpencerMDandJ. C. ThompsonMD.THE MORBID ANATOMY OF THE HUMAN BODY: by MatthewBaillie. Commentary and reconstitution by HaroldAttwood.HARDY'S TEXTBOOK OF SURGERY: by JamesD. Hardy.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01473.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1989.tb01474.x

出版商:Blackwell Publishing Ltd    

年代:1989

数据来源: WILEY