ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04512.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04513.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The accuracy of inguinal ultrasonography in the pre‐operative localization of the maldescended testis was assessed in 51 patients with 57 maldescended testes. Pre‐operative sonographic results were compared with the clinical assessment and the operative findings. Testes located in the inguinal canal or at the internal ring, which were occasionally impalpable, were readily demonstrated by sonography. The management of children with an impalpable maldescended testis should include a sonographic examination as the investigative procedure of cho

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04514.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

A series of 97 patients has been studied who were treated for liver injury at Westmead Hospital between Jaunaury 1979 and January 1985. Patients were noted to be younger than those reported in previous series from Sydney, and to have suffered more frequent, significant, head injuries. Paramedical roadside intervention probably allowed more patients to reach hospital alive than was the case before the advent of the Intensive Care Ambulance system. Improved organ imaging has allowed more confident non‐operative management of 13% of patients. Hepatic resection has been used infrequently (10%). Packing has been used in six patients as part of the definitive treatmen of severe injuries and coagulopathy, and to allow the transfer of a further seven patients from peripheral hospitals. Ten of these 13 patients survived. Head injury continues to be a major cause of death in these patients. Death from the liver injury itself is usually associated with high grade damage to the liver and the associated hepatic veins and vena cava. It is speculated that improvement in the management of these lethal injuries will come about only from the early identification of patients likely to have suffered such trauma, and the pre‐operative control of bleeding. Balloon catheter placement under radiological control, to tamponade the inferior vena cava and abdominal aorta, is suggested as one means by which this goal might be achie

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04515.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Significant hypersensitivity reactions to heparin may manifest as either delayed onset thrombocytopenia or as necrotizing skin lessions. Such hypersensitivity reactions are uncommonly recognized, partly because of their rarity and partly because their existence is not widely appreciated. Both adverse reactions may be readily diagnosed. In the presence of these reactions, continuing heparin therapy may lead to serious thrombo‐embolic complications and death of the patient. In this study, two patients who highlight the clinical settings of these reactions are discussed with reference to their pathogensis and clinical significanc

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04516.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Intraluminal pressure recordings from the sphincter of Oddi (SO) have made significant contributions towards the understanding of normal SO function and are being used for the diagnosis of SO motility abnormalities. In this study the endoscopic intraluminal methods for measuring SO pressure changes have been adapted for use under sterile conditions during surgery on the biliary system. Sphincter of Oddi pressure measurement in a group of patients undergoing elective cholecystectomy for gallstones, were compared with a group of control subjects undergoing endoscopic study of the SO. There was no significant difference in CBD pressure, SO basal pressure, SO wave amplitude and SO wave frequency. However, a highly significant difference was noted in the propagation direction of the SO contractions. The control subjects had a predominance of antegrade contractions whereas patients undergoing cholecystectomy had a predominance of retrograde contractions. This result suggests an association between SO motility disorder and the presence of gallstones.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04517.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Arteriovenous fistula is a rare complication of lumbar disk surgery and there is often a delay in diagnosis. A patient who developed multi‐system failure associated with an aortocaval fistula, which occured following a lumbar disk operation, is presented in this study. Surgical repair was facilitated by the use of total cardiopulmonary bypass which enabled a degree of safety and control that would have been difficult to obtain with standard method

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04518.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Phetobezoar impaction is an important cause of small bowel obstruction in patients who have had previous vagotomy and drainage procedures for duodenal ulcer. Most casesl present with typical symptoms and signs of small bowel obstruction, but in some there are no definite radiological signs of bowel obstruction and plain X‐ ray. In these the phytobezoar is often located by barium studies. Operation is required in the majority of cases and the phytobezoar milked into the large bowel or removed at enterotomy. Before laparotomy is performed, it is essential to endoscope these patients to avoid overlooking gastric phytobezoars which are easily removed via a gastrotomy at the time of the laparotomy. The incidence of phytobezoar obstruction will be reduced by the giving of simple dietary advice and by employing highly selective vagotomy whenever possible in the surgery of duodenal ulce

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04519.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The management of 40 intracranial aneurysms using profound hypothermia and cardiac arrest are reviewed. The technique is described and the reasons for using this procedure are discussed. It is suggested that this technique is of value in the treatment of giant aneurysms, aneurysms which could not be treated by conventional methods, multiple aneurysms, aneurysms in difficulat sites and aneurysms complicated by other hazards. such as vascular anomalies.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04520.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Oestrogen receptors were measured by a histochemical technique in tumour tissue from 45 patients with breast cancer, and the results compared with receptor levels measured by a standard biochemical dextran‐charcoal assay. Histochemical measurements were made by incubating frozen sections of tumour tissue with 17‐fluoresceinated oestrone, using dithiothreitol to inhibit uptake by low affinity binding sites, and estimating receptor content by the extent of fluorescence seen microscopically. Results from the two assays gave varying estimates of receptor concentration, with 66% of patients classed as receptor‐positive by the biochemical assay, and 44% of patients classed as receptor‐positive using the histochemical technique. Because of these discrepancies the histochemical assay cannot be considered a direct substitute for biochemical receptor measurements. Progesterone receptor was detected by biochemical measurement in 80% of the subgroup of patients who were positive for oestrogen receptor in both assays. The histochemical assay may thus identify a subset of those patients considered oestrogen receptor‐positive by conventional receptor assays, and this group may be more likely to respond to hormonal therapy. However, whether the histochemical method provides a predictive measurement for endocrine responsiveness which is superior to standard progesterone receptor assay remains to be d

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb04521.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY