ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06381.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06382.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

摘要:

SummarySome of the basic pathological problems in connection with the surgery of defined types of major arterial obstruction are discussed.The results of surgical treatment at Green Lane Hospital of cases with congenital, traumatic, embolic and degenerative obstruction is recorded and discussed together with a table of statistics of wounds involving arteries of the New Zealand Armed Forces.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06383.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

摘要:

SummaryA method of obtaining histological sections of bone which has not been decalcified is presented. The method is applicable mainly to cancellous bone but can also be used on cortical bone which is not too dense. The importance of this method in the understanding of normal structure and interpretation of pathological conditions is well recognized and a brief account of results already obtained is given, with representative photographs to illustrate these.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06384.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06385.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

摘要:

Summary1. A series of 111 cases of anal fistula has been studied.2. There were 3 cases of submucous anal fistula. Each of these cases possessed a track which passed deep to smooth muscle. This muscle may be muscularis mucosae alone, but part or whole of the internal sphincter may be included.3. The majority of anal fistulae were classified as peri‐anal anal fistulae because they appeared to be the sequel of a perianal abscess. There were 81 cases; in 11 no internal opening could be found, whilst in 3 there was no external opening.4. In 24 cases, the fistula appeared to involve primarily the ischiorectal fossa and, in most, to originate in the middle line posteriorly, very close to the ano‐rectal ring. The fistulous track lay in the deep post‐anal space and usually involved one or both ischiorectal fossae. An external opening was absent in two patients. Secondary tracks may lie in the peri‐anal space and, in two, secondary tracks passed through the iliococcygeus portion of the levator ani muscle.5. In 3 cases the fistula coursed from an external opening in the skin to an internal opening in the rectum. The pathology of these was uncertain, but they did not appear to be a sequel of ischiorectal infection.6. It is believed that the term “ano‐rectal fistula” should not be applied to any one type of fistula, but should be used in the widest sense of the term to include all fistulae in the region. Classification should be revised to incorporate modern views on the anatomy

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06386.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

摘要:

Summary1. A series of 24 patients with an ischiorectal anal fistula (ano‐rectal fistula) were subjected to operation.2. In 20, the fistula was classified as a posterior ischiorectal anal fistula because the internal opening was situated in the middle line posteriorly. The fistulous track ran in the ischiorectal fossa either on one or on both sides. An external opening was present in 18 and absent in two. Secondary tracks in the peri‐anal and supra‐levator spaces were sometimes present.3. In three patients the fistula was classified as an anterior ischiorectal anal fistula because the internal opening was in the middle line anteriorly.4. In one case no internal opening was found. It was the first case in the series.5. In 22 of the 24 cases of this series the fistula was treated by a one‐stage operation in which the whole track was laid open and the resulting wound covered by a primary skin graft. In one case the wound was too vascular and the graft deferred for two days whilst in the other‐case no graft was applied because of the desire to have the patient out of bed to void within a few hours of the operation.6. Despite the long operation there has been no operative or post‐operative mortality.7. In 20 cases, 90 per cent, or more of the graft was successful and the wound almost healed within 7 to 10 days of the operation. In the remaining three cases part or whole of a sheet of skin failed either because of haematoma formation or because it had been displaced during the application of the dressings. In the least successful result there was approximately a 50 per cent. “take.”8. Therc was only one recurrence; this was in the first case of the series in which an internal opening was not discovered.9. All patients were continent, although for a week or two after the operation there was a tendency for the sphincteric function to be inadequate. In 22 patients the sphinctcr muscle seemed as strong to the patient as it did before the operation. In the othcr two, there was some weakness when the motions became loose.10. In three patients there was a small, symptomless partial mucosal prolapse.11. The deformity produced by laying open and skin grafting this large fistula has not been a cause for complaint

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06387.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

摘要:

SummaryThe case histories are reported of 4 patients with extensive burns, all showing the common features of early oliguria or anuria with severe haemoglobinuria in the absence of a hypotensive phase as estimated by the systolic blood‐pressure.The renal histology was studied in aspirates taken immediately after death and revealed varying phases of acute tubular necrosis. As the patients died seven hours, forty‐eight hours, five days and twelve days after injury, it was possible to observe both the early and the late changes present in the tubular epithelium. The necrosis was most pronounced in the forty‐eight hours' specimen corresponding clinically to total anuria. At five days tubular regeneration had commenced, coinciding clinically with the early diuretic phase.The production of these renal changes is discussed and it is suggested that renal vasospasm, haemoglobinaemia and oligaemia are the principal contributing factors. An appreciation of the renal changes is of value in the planning of trea

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06388.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

摘要:

SummaryNeither cortisone nor 9α‐fluorohydrocorti‐sone acetate alone provides adequate steroid replacement in adrenalectomised patients: cortisone because its mineralocorticoid action is insufficient in comparison with its glucocorticoid action, and 9α‐fluorohydrocortisone acetate because the converse is true. By using both these steroids a proper balance can be achieved. One patient, who has been studied in detail for a year following bilateral adrenalectomy, is being satisfactorily maintained with 0.1 mg. 9α‐fluorohydrocortisone acetate and 20 mg. cortisone twice dail

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06389.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY

摘要:

SummaryEvidence is presented that in the malignant cell of rat liver tumours a highly specific cellular protein has either been lost or has been modified; this is judged by the cell's control the growth of tissues and organs and, in ordinary circumstances, limit the proliferation of tissue cells.The significance of these observations in human neoplasms is as yet uncertain. However, this is being studied and if the staining technique should prove applicable it will be not only a valuable method of investigating tumours but possibly also important in differentiating tumour‐like masses from true neo‐pla

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1957.tb06390.x

出版商:Blackwell Publishing Ltd    

年代:1957

数据来源: WILEY