ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04196.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Henry Joseph Windsor, who died the year before last at the age of 91, endowed this annual Lecture in 1972. His son, Harry, gave the first lecture. Its title was “How far that little candle throws his beams,” and he quoted Portia's words fromThe Merchant of Venice“How far that little candle throws his beams. So shines a good deed in a naughty world.” That text seemed fitting for his father, whose deep religious convictions shone so clearly in cynical and pragmati

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04197.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

4This paper describes an exercise in cooperative research between the Health Commission of New South Wales and a professional body — the Neurosurgical Society of Australasia. This exercise has provided an encouraging example of a professional body accepting responsibility for, and monitoring, its own standards of health care, assisted with data and advice from the health authority. The Neurosurgical Society used the Commission's extensive data from the hospital morbidity data collection system. This system is briefly described. The results of this work were presented to an international symposium on head injuries. Several major problems existing in this field of neurosurgery were identified, and their various clinical and organizational aspects are being further researched, for the Society to formulate recommendations for solutions. This experience demonstrates the value of such cooperation and provides an example which could be followed by other disciplines of surgery. The need to supply the highest quality of care, the high cost of medical services, and increasing consumer interest in the outcome of treatment, indicate an increasing need for review of the results of surgical treatment. It is preferable that such a review is conducted by the profession, in cooperation with a governmental health authority, rather than by the latter body alon

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04198.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

In 1974 a project was initiated in which patients with apparently operable breast carcinoma underwent special Investigations in an attempt to identify occult metastases in bone and liver. One hundred and seventy‐two patients have been followed for two years or more and their axillary node histological findings reviewed. From analysis of these patients the following conclusions may be drawn. Careful clinical assessment, especially measurement of the primary tumour and palpation of the axillary nodes, remains a fundamental guide to the likelihood of early recurrence. Histological confirmation of node metastases is as valuable as clinical assessment, but is not superior unless other features of node histology are considered. Micrometastases do not increase the probability of early recurrence except in comparison with a group whose nodes lack both metastases and other unfavourable features. The majority of special Investigations do not have additional predictive value, though a bone scan is useful in the small number (less than 10%) in whom it is positiv

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04199.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

The Breast Adjuvant Chemotherapy Study of the Anti‐Cancer Council of Victoria was set up to encourage the cooperation of clinicians from many centres who are involved in the management of early node‐positive breast cancer in Victoria. Data sheets were completed by participants, and an analysis was made of the first 100 registered patients to determine the reliability of clinical assessment related to pathological findings and to study the extent of axillary node clearance. Although all subjects were histologically node positive, 47 had no palpable axillary lymph nodes, and in only 38 were nodes considered to be clinically involved. Correlation between clinical and pathological measurements of breast tumour size was significantly better (86%) with tumours over 5 cm in extent than with tumours of 5 cm or less (70%). Total mastectomy with total axillary clearance was the most common operative procedure performed. The pectoralis major was preserved in 97 and the pectoralis minor was divided or removed in 71 cases as part of the axillary clearance. In a subgroup (33) the location of involved nodes in the axilla was studied, and of these seven (21%) were found to have involved upper axillary nodes in the absence of lower axillary nodal involvement, emphasizing the inadequacy of axillary sampling in determining nodal sta

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04200.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Two patients with ileocaecal tuberculosis diagnosed by colonoscopic examination and biopsy are reported. Multiple colonic biopsies from the lesion revealed granulomas in both the patients.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04201.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

Sixteen patients were diagnosed as having a benign mesenchymal tumour of the colon or rectum at the Repatriation General Hospital, Concord, between 1950 and 1979. There were six lipomas and ten leiomyomas. Lipomas occurred more commonly in the colon, while leiomyomas predominated in the rectum. The symptoms produced by the lipomas included abdominal pain, rectal bleeding and diarrhoea. Leiomyomas were found incidentally at sigmoldoscopy in six patients, while three presented with rectal bleeding and one with constipation. Lipomas were larger than leiomyomas and were associated with more complications. Both tumours, however, produced few physical signs.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04202.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

A review of the hospital course of 82 splenectomies in children performed in the past 15 years has been carried out. Three indications have been identified: therapeutic, diagnostic, and traumatic. Thalassaemia was identified as the commonest indication. Comparisons of the spleens removed showed that those from thalassaemia patients were the biggest, while those removed for idiopathic thrombocytopenic purpura (ITP), lymphoma staging, and trauma, were small. Twenty‐eight per cent of patients had accessory spleens. Intrathoracic complications were frequent in the traumatic cases, whereas wound complications were commoner after splenectomies carried out for haematological reasons. No gallstones were detected. The platelet response to the various indications was studied and compared. There were two postoperative death

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04203.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

This paper details the results of an eleven‐year survey of patients admitted to the burns unit at the Royal Brisbane Hospital with injuries secondary to motor vehicle accidents. There were 64 subjects in this group. Forty‐five were involved in car accidents and 19 in cycle accidents. Fifty of the patients were male, with a mean age of 26.9 years. The mean age of the 14 females was 24.9 years. Petrol fires emerged as the major source of injury in those individuals involved in car accidents, while hot metal injured most of the cyclists. Cyclists did not seem to be more prone to friction burns than motorists. Burns to the limbs predominated, but respiratory burns occurred in seven of the eight patients who did not survive. The median duration of hospitalization was 21 days, and the death rate in this series was 12

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04204.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY

摘要:

There is evidence from a number of centres that some forms of locally advanced and aggressive cancers which are difficult to eradicate by standard means can be reduced by the use 01 “basal” chemotherapy to a degree which will allow more certain tumour eradication by subsequent radiotherapy and/or surgery. Clinicians have been divided as to whether there is an advantage in giving the chemotherapeutic agents directly into a regional artery of supply where this is feasible, as opposed to their systemic administration. This paper documents supportive evidence that some and possibly many chemotherapeutic agents are more effective if given regionally into an artery of supply. There is a higher incidence of local side‐effects in the region infused, including loss of hair, inflammatory changes, and ulceration of the skin or mucosa of the region infused. After intraarterial infusion of tagged bleomycin (indium‐Ill bleomycin) into a limb, the radioactive isotope remained more concentrated in the limb infused than in the opposite limb for at least 24 hours. Systemic side‐effects, including bone‐marrow depression, are less frequent and less severe in patients given chemotherapeutic agents by intraarterial infusion than if the same doses of agents are given intravenously. There is now sufficient evidence of the value of basal chemotherapy used in this way to make it mandatory that medical oncologists and surgeons, working together, should plan controlled studies to determine the most appropriate applications of this technique of

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1980.tb04205.x

出版商:Blackwell Publishing Ltd    

年代:1980

数据来源: WILEY