ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07507.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07508.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A prospective study was carried out to determine what effects publication within a multiple=choice question (MCQ) book of 63 selected items from a bank had on their performance in subsequent examinations. A closely corresponding group of 63 unpublished questions set both before and after publication of the book was used as control. The specific outcomes studied were those on famility index,rbiserial discriminating index and differences in performance between abler (upper 25%) and weaker (lower 25%) candidates.The mean facility index of the published questions inreased significantly (P0.05) questions. Contrary to expectations the mean facility index of published questions increased, after publication, to a greater extent (P<0.01) for abler andidates than for weaker candidates.The study supports the hypothesis that publiation of questions from a bank makes them easier to answer. The practice of adjusting the cut‐off mark for passing according to the proportion of published questions in a make greater use of the MCQ book in preparing for an examinatio

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07509.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Surgery is a very resonal exercise and no two surgeons use an identical technique. Traditionally, operative expertise has been acquired through a system of apprenticeships. Pettigrew has shown that operative performance is the main factor in determining postoperative complications and therefore the length of hospital stay, and surgical journals have recently returned to technique as a topic of debate.1‐4Certain skills, such as knot tying, can be learned procedures, including fracture fixation.5,6This article describes an anatomosis workshop held in New Zealandrecently for general surgical tramine

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07510.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

This study reports the results of primary flexor tendon repair combined with closure of the tendon sheath in 31 Zone 2 injuries. In 3 digits, the profundus tendon alone was divided. IN a further 7 digits, one tendon was completely divided and the other was incompletely divided. The remaining 21 digits involved complete division of both tendons.Assessment of the results according to the total active motion (TAM) system found 86% of the repairs in the excellent, good and fair categories. Two ruptures occurred (6%). A second assessment employed the criteria of Strickland, excluding the motion of the metacarpophalangeal joint. The results obtained following suture of both tendons were: excellent (39%); good (36%); fair (14%); poor (4%); and rupture (7%).These results lend support to the belief that closure of the tendon sheath dereases external adhesion formation and improves motion without increasing the risks of rupture.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07511.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A pilot study of the effectiveness fo prehospital triage of trauma patients was carried out in western Sydney between February and July 1988. Triage guidelines were developed to identify seriously injured persons at the incident site who might warrant admission to a Level 3 Trauma Service Hospital (Trauma Centre), as part of the NSW Department of Health trauma services plan.1The study results were based on 64% of ambulance trauma transports for which a triage decision was provided. Of trauma transports studied, 3.7% had injuried serious enough to warrant admission of Leel 3 Trauma Service Hospital. Ambulance officers correctly triaged 77% of these cases in the field. However, 62% of tauma transports triaged 'severe’or‘critical’did not have injuries serious enough to warrant admission to a Level 3 Trauma Service Hospital. Nevertheless, the triage guidelines compared favourably with similar instruments used elsewhere.2,3Based on the performance of the triage guidelines it was concluded that the introduction of a regionalized trauma service in metropolitan NSW with local bypass is pos

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07512.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The use of red cell saving machines is described in 16 cases of aortic reconstruction. There were 3 deaths in the series, all unrelated to use of the technique. Salvaged autologous blood accounted for 45% of red cell requirements. Biochemical and haematologic parameters were monitored before, during and after operation. When large volumes of blood are salvaged, the system becomes cost effective and the risks of homologous transfusion are reduced.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07513.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A review of three cases of aortic aneurysm in association with a horseshoe kidney is presented. Both the transperitoneal and retroperitoneal approaches to the aneurysm are detailed and the relative advantages and disadvantages outlined. The conventional approach of transection of the renal isthmus is not recommended because of the possibility of damage to the collecting system of the horseshoe kidney. The place of specialized investigations is outlined.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07514.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

An analysis of the clinicopathological features of 45 cases of desmoplastic, neural transforming and neurotropic melanoma assessed by a single pathologist are reported. The age range of 27 males and 18 females was 17‐88 years. Twenty primary lesions (44%) were on the head and neck and fourteen (31%) were on the trunk. Thirty lesions (67%) were amelanotic). The initial clinical diagnosis was incorrect for 16 patients. Mean thickness was 4.5mm. Recurrence occurred in 17 patients (38%). Local recurrence has occurred in 12 patients. This was related to a primary where: pathological diagnosis was incorrect; excision was less than 1 cm; the site was on the head and neck; Clarke level was V; and Breslow thickness was>4 mm. Four patients had cranial nerve neuropathies due to recurrent neurotropic melanoma. Four patients are alive with inoperable disease and five have died from disseminated melanoma. These tumours can be difficult to recognize clinically and pathologically, with poor results if not adequately treated primarily. Therefore, the need for surgeons to be aware of this tumour and its clinicopathological features is important. Close follow‐up is essent

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07515.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Nineteen consecutive patients, 7 male and 12 female, underwent pancreaticoduodenectomy for malignancy during the 3‐year period 1985‐88. The pancreatic remnant in the first 12 patients (Group 1) was managed alternately by pancreaticojejunostomy (PJ) and pancreaticogastrostomy (PG). Patients undergoing PJ and PG (6 each) were comparable in age, biochemical parameters and nature and extent of disease. Three patients, all in the PJ subgroup, died (25% mortality) due to pancreatic leak, biliary leak and hepatocellular failure. In view of the high complication rate following PJ, the remaining 7 patients (Group 11) underwent PG. For patients undergoing PG, the hospital stay was shorter, complications were fewer and there was no anastomotic leak or death (0% mortality). This study represents the first attempt at comparison of PJ with PG in reconstruction following the Whipple procedure by the same team. The results suggest that PG deserves wider applicat

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07516.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY