ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01861.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

A new method of assessing venous ulceration has been developed using a camera, slide projector. viewing box and planimeter. This method is accurate and reproducible. Thirtcen patients with chronic venous ulcers wcrc studied. The method enabled a healing curve to be constructed for cach ulcer. The healing rate for the group was determined by construction of a linear regression line of best fit through the averaged data points. This method allows accurate comparisons to be made bctween treatment regimes.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01862.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The records of 90 consecutive adult patients, who presented after blunt abdominal trauma and who underwent diagnostic. percutancous peritoneal lavage over a 3 year period, were reviewed. Lavage effluents were considered positive, negative or equivocal. An equivocal result was one where the tubing contained blood stained fluid, but it was still possible to see newsprint through the tubing. Fifty‐one lavages were positive 24 negative and 15 equivocal. All 51 patients with a positive effluent and three of the patients with an equivocal efflucent had a laparotomy and in all but one case a significant injury was found. There were no false negative results. In a single patient the transverse colon was perforated during the insertion of the lavage catheter. Diagnostic percutaneous peritoneal lavage is a simple, safe, rapidly performed, accurate technique designed to detect intraperitoneal blood and the results of this review suggest that it has a role to play in the decision‐making process when assessing adult patients who have suffered blunt abdominal tra

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01863.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

This paper reviews the classification of tumours affecting the palate. The embryology and anatomy of the palate are outlined in relation to the TNM classification of thc International Union Against Cancer (UICC) and American Joint Committee on Cancer (AJC) for the oral cavity and oropharynx. A series of 80 palatal tumours is reviewed to assess the adequacy of the classification schemes in providing accurate data for tumour treatment comparison. Both schemes rely on relatively crude assessment of total tumour extent and neither provides enough detail to allow valid comparisons.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01864.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Patients with recurrent high bile duct strictures pose special problems for management. Relief of obstruction by hepatieojejunostomy is usually possible but the standard technique does not permit long term access. Six patients with benign strictures involving hepatic ducts have been treated by a simple modification of hepaticojejunostomy retaining access for either balloon dilatation of intrahepatic strictures or investigation and treatment at a later stage if problems recur. Employing a longer than usual Roux‐en‐Y loop, the sutured anastomosis of right and left hepatic ducts is performed 10–15 cm from the free end of jejunum. Silastic tubes are placed into each hepatic duct crossing the anastomosis to exit from the free end of the jejunum which is closed around the tubes. The closed end of jejunum is buried in the peritoneum deep to linea alba and the tubes emerge in the epigastrium. Safe access is retained via the tubes. If the tubes are removed, a ‘mini‐lap’ will expose the Roux loop for endoscopic or radiolog

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01865.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Delayed hypersensitivity skin test reaction was evaluated using Multitest CMI, an implement which provides seven standardized antigens in a single application. Eighty‐two patients requiring Total Parenteral Nutrition for a variety of conditions were studied. The incidence of anergy was 65%. Seven anergic patients died, but there were no deaths in the reactive group, this difference being significant (P= 0.04). There was a significant association of anergy with carcinoma (P= 0.007) and anergic patients with carcinoma had a significantly greater risk of dying than reactive patients without carcinoma (P= 0.038). Anergic patients also had significantly lower nutritional parameters of serum albumin (P= 0.04), transferrin (P<0.001), absolute lymphocyte count (P= 0.009) and mid‐arm muscle circumference (P= 0.02) compared to the reactive gr

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01866.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Percutaneous transluminal angioplasty (PTA) was attempted on 70 occasions in 63 consecutive patients presenting with advanced ischacmia. The procedure was technically succcssful in 64 (91%) with hacmodynamic improvement in 39 (56%) and clinical improvement maintained at 6 months in 51 (73%). Follow‐up ranged from 6 months to 4 years and life‐table analysis showed 60% succcss at 1 year and 58% success at 2 years. Overall limbsalvage was 76%. Complications occurred in 6 (9%) and in one case this lead to amputation. The relationship of a number of associated factors to outcome was assessed. The presence of cardiac disease requiring treatment for failure or angina was a highly significant adverse factor (P<0.001). Decreasing age and greater extent of disease were also significant adverse factors (P<0.05). Therefore, because of its low morbidity and cost. PTA can be seen as a useful procedure in patients presenting with advanced peripheral vascular dis

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01867.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

This paper reviews the indications for obturator bypass and adds five more cases to the 29 reported in the literature. The indications were groin sepsis, fear of sepsis, severe groin scarring and false femoral aneurysm. The graft material was variously alone or in composite fashion saphenous vein, arm vein, umbilical vein, dacron and PTFE. All patients are alive but one graft occluded at 12 months and another required ligation at 5 days because of further infection and haemorrhage. The other three are patent at 5, 4 and 2½ years

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01868.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The results of 222 cases of hypertrophic pyloric stenosis operated on at the Princess Margaret Hospital for Children in Perth, from 1979 to 1984, have been reviewed. There were no deaths, but there was a 7% incidence of wound infection and a 72% incidence of postoperative vomiting. Staphylococcus Aureus was cultured from 62% of the infected wounds. Prophylaxis against Staphylococcus Aureus infection and delayed introduction of feeding are suggested.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01869.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Bypass grafting to vessels beyond the popliteal bifurcation is an established method for treating severe limb ischaemia. Failure rate is high, however, especially when prosthetic vascular substitutes have to be used. When leftin situ, saphenous vein can be used down to much smaller diameters than would be possible with reversed vein. With this method, vein utilization of around 90% can be achieved with respective increases in patency and limb salvage. Our early results with 26in situgrafts are presented. In two cases the presence of a suitable tributary of the saphenous vein allowed a ‘bifurcated’ or ‘femorobitibial’ graft to be performed. All patients (17 males, nine females) were admitted with limb threatening ischaemia. Mean ankle pressure index was 0.29 (s.d. = 0.09), range 0.18–0.53. Average graft intra‐operative flow rate measured 96 ml/min. Twenty grafts remain patent while six grafts have failed. In three of these failures, performed early in the series, the graft could not be made to function at the time of surgery. The mean postoperative ankle pressure index was 0.87 (s.d. = 0.19). Cumulative patency rate at 24 months in 74%. This rises to 83% if the three ‘on table’ failures are excluded. Five amputations were required; four as a result of graft failure and one despite a functioning graft. Four grafts clotted within 24 h but have remained patent following immediate thrombectomy. One patient required ligation of an arteriovenous fistula on the third po

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb01870.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY