ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02497.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02498.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02499.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

We present a diagnostic approach to the various clinical presentations of patients with cerebrovascular disease. It involves grouping the patients into five categories: (1) asymptomatic, (2) transient neurologic episodes, (3) unstable neurologic deficits, (4) prolonged neurologic deficits and (5) completed stroke. An algorithm is given for each category and an approach to management is outlined. The algorithms are clinically validated by reviewing the results of 185 reconstructive operations performed on patients with manifestations of cerebrovascular disease who were managed following the algorithms.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02500.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Twenty‐one patients with 22 carotid aneurysms have been managed between 1960 and 1982. The aneurysms were congenital (3), atherosclerotic (8), false aneurysms after previous carotid operation (10) and mycotic (1). Carotid ligation was performed on four patients, one of whom suffered a stroke and died. Carotid reconstruction was undertaken in 15 patients without operative mortality but with postoperative strokes in two. Autogenous repairs of the carotid are recommende

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02501.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

A series of 101 patients with carotid fibromuscular disease have been treated and followed for at least one year. Transient ischaemic attacks and amaurosis fugax were the most common presentation, while 22% of patients had had a completed stroke prior to surgery. Graduated dilatation was the most commonly used surgical method. In 150 operations, there were no deaths and three operative strokes. The operative repair has proven to be very durable and associated with a low incidence of neurologic events.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02502.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Twenty‐seven patients with spontaneous dissection have been managed between 1966 and 1982. Most presented with focal neurologic symptoms and 33% had had a completed stroke. Because of early failures of attempted operative repair, expectant management was adopted in 17 patients, none of whom had further neurologic events. The artery had re‐expanded to a new normal caliber in 9 of 10 patients evaluated by angiogra

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02503.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Twenty‐one patients with 22 carotid body tumours have been managed between 1963 and 1982. All presented with a neck mass and, if the tumour was extensive, pain. The diagnosis was made clinically, by ultrasound (2) and by angiography (16) and confirmed by biopsy in 19 patients. Eighteen resections were performed, without mortality but with a stroke rate of 16% and an overall complication rate of 36%. Four patients required reconstruction of the internal carotid arter

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02504.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

The endoscopic diagnoses of 51 patients with carcinoma of the oesophagus and cardia were studied. Tissue for histology and cytology was obtained through either the flexible (28) or rigid (23) endoscope and the results compared. Squamous cell carcinoma was diagnosed accurately (100%) by either method. Adenocarcinoma was poorly diagnosed by flexible endoscopy (five out of 13 with one false positive) while rigid endoscopy remained accurate (six out of six). Misdiagnosis with the flexible endoscope has been shown to occur in the presence of inflammation of the mucosa or tumour infiltration of the submucosa of the lower oesophagus. This has been attributed to the inadequacy of the specimen size for accurate diagnosis in these circumstances.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02505.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY

摘要:

Six patients with polyposis coli and five with chronic ulcerative colitis underwent total colectomy and mucosal proctectomy with preservation of the anal sphincter and levator ani muscle. An ileal reservoir, constructed from the terminal ileum, is brought out through the anal sphincter for anastomosis to the anus at the dentate line. Two patients in the series had a three‐limb reservoir with anastomosis of a short efferent ileal limb to the anus (Parks technique). Nine patients had a two‐limb J‐shaped reservoir with the apex of the reservoir anastomosed to the anus (Utsunomiya technique). All patients had a temporary defunctioning ileostomy. There were no deaths. Two patients suffered from severe infection within the rectal muscle cuff. One resolved completely with spontaneous drainage into the reservoir; the other had continuing sepsis and eventually required excision of the anus and conversion to a continent ileostomy. All patients remain in good general condition with no disturbance of urinary or sexual function. Continence is satisfactory in all patients but two wear a pad at night. All evacuate their reservoirs spontaneously: none requires the use of a catheter. For most patients stool frequency varies from four to eight times daily but two patients have more frequent bowel motions. Colitis patients have more frequent bowel activity than those with polyposis. Three patients take Imodium tablets to lessen bowel frequency. The operation should be reserved for specialized centres and is still under trial; however, it appears likely to become the operation of choice for all patients with polyposis coli and for many patients with chronic ulcerative co

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1983.tb02506.x

出版商:Blackwell Publishing Ltd    

年代:1983

数据来源: WILEY