摘要:

Anex vivoisolated perfused porcine liver model was tested to assess its suitability for rapid, reliable and relatively cheap testing of organ preservation solutions for liver transplantation. The model consists of a machine driven recirculating system incorporating an organ chamber. blood pump and membrane oxygenator. Autologous blood was used for perfusion for a period of 2 h at a temperature of 37°C. The model was tested with five groups of livers which had sustained varying degrees of injury ranging from minimally damaged to those known to be incapable of sustaining life when used for liver transplantation. The groups of livers were: (i) controls; (ii) preserved in University of Wisconsin solution (UW) for 6 h; (iii) preserved in an albumin‐based extracellular fluid (ALB) for 6 h; (iv) preserved in UW for 18 h; and (v) preserved in ALB for 18 h. Bile production was found to be a reliable parameter of preservation damage. Changes in perfusate levels of aspartate aminotransferase, potassium, glucose and calcium also occurred in relationship to preservation damage. In contrast, weight gain of the liver, sequestration of the white cells and platelets in the liver. urea production and oxygen consumption were unreliable predictors of liver damage. Histology of biopsy specimens revealed apparently well preserved livers in all cases after preservation but before perfusion, but serious abnormalities after perfusion in long preserved livers, with features in these suggestive of damage to the sinusoidal endothelium. We believe that the model is a worthwhile adjunct to research into liver preservati

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00033.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The medical course at the University of Queensland is 6 years in length. After studies in basic sciences, the fourth year consists of systematic pathology, clinico‐pathological correlation and the learning of clinical methods. During the fifth year the core surgical knowledge base is taught. The sixth year is spent in clinical ward work aimed at problem‐orientated consolidation of knowledge and skills, and the learning of applied therapeutics.We studied whether the surgical knowledge base taught to our fifth year students was retained a year later by the same students in their final year. A standardized post‐test examination which had been presented to the students during their fifth year in 1990 was again presented to them during their sixth year in 1991. We found that the surgical knowledge base of this group of students remained the same in their final year as it had been in their penultimate year.We suggest that to continue testing core surgical knowledge once it has proven satisfactory is not productive. These students should progress to further clinical studies aimed at improving their problem solving ab

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00034.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Carl Langenbuch performed the first cholecystectomy at the Lazarus Hospital in Berlin in July 1882. This operation followed scientific experiment, careful thought, cadaver dissections and careful patient selection.Langenbuch's career was linked with the Lazarus Hospital in Berlin, to which he was appointed as Director at the age of 27. The hospital was then 4 years old and in a poor area of Berlin, and they grew in reputation together. Going through repeated troubled times. this hospital has withstood financial disaster, three wars, an occupation and the ambitions of administrators and developers.Treatment for cholecystitis before Langenbuch was stone extraction from spontaneous cutaneous biliary fistula or skin incision of near‐pointing empyema. Cholecystostomy was carried out by Bobbs (I 867). by Sims (1878), and championed by Kocher (1878) and Tait (1879). Langenbuch carried out a cholecystectomy in 1882 and subsequently recommended choledochotomy, duodenotomy and sphincterotomy in the management of stones in the bile ducts. He carried out one of the earlier major right liver resections in 1888. Also, he was famous for his sciatic nerve stretching for tabes dorsalis, management of gunshot wounds and his dissertations at the German Surgical Society before becoming renowned for cholecystectomy.The surgical world owes Langenbuch proper acknowledgement for his contribution to hepatobiliary surger

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00035.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00036.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Sterilization by tubal occlusive methods has a small but definite incidence of failure which is not well recognized among general surgeons. As a result of the failure to appreciate the possibility of ectopic pregnancy after tubal ligation, right‐sided abdominal pain in this patient population is commonly misdiagnosed as appendicitis. One such case is presented, and the literature is reviewed and discusse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00037.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00038.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Rupture of an intra‐aortic balloon counterpulsator (IABCP) demands immediate removal. We report a case of thrombus formation within a Datascope IABCP secondary to IABCP rupture, necessitating surgical exploration for removal. There is a disturbing pattern of balloon ruptures with this type of IABC

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00039.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Neutropenic enterocolitis is a complication of patients receiving chemotherapy for malignant disease. It has a characteristic presentation and may lead to gut perforation with consequent high mortality. It is best treated by early surgical intervention. Considerable mortality is inevitable in these gravely ill patients.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00040.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

The development of a right chylothorax following left radical neck dissection for melanoma is reported. Chylothorax following neck dissection is extremely rare, with only 12 cases documented in the literature. Seven of these were bilateral and three were unilateral (all left‐sided); unilateral right chylothorax after neck dissection has not been reported previously. Chylothorax is more common after intrathoracic surgery or trauma. Regardless of its cause, the condition is potentially serious and sometimes fatal. Our patient was successfully managed without further surgery. The aetiology and management of chylothorax following neck dissection are discusse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00041.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1993.tb00043.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY