ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00977.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00978.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Photoradiation therapy depends on the selective retention of a photosensitizer within the tumour followed by activation of the sensitizer by irradiating the tumour with light of the appropriate wavelength. The present methods of treatment of cerebral glioma are inadequate and the possible benefit of utilizing photoradiation therapy to obtain improved local control of the tumour has been studied in the laboratory and in clinical trials. The biological basis for photoradiation therapy and the laboratory studies and clinical trials involving the use of photoradiation therapy to treat cerebral tumours are discussed.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00979.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00980.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The results of a screening programme for colorectal neoplasia in a high risk group using an immunochemical test for blood has been reported recently. This test is known as the faecal human haemoglobin (FHH) test. This paper reports the results of rescreening this group after an interval of 1–2 years. The FHH test was compared with a paper disc method.All individuals with positive tests were investigated and those with negative tests were offered investigation. The results confirm the value of the FHH test in screening a high risk group: 19 individuals in 1153 participants were found to have a significant neoplasm (1.6%). The predictive value of the test for a significant neoplasm was 42%. A false negative rate of 2.6% was found, all lesions being benign. It appears to be more reliable than the paper disc method but the differences do not reach statistical significance.The FHH test is recommended for screening the general population over the age of 40 years, with rescreening annuall

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00981.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

A retrospective study is presented of 200 cases of diverticular disease admitted to Auckland Hospital over the 6‐year period 1979–84. The epidemiology of the total group, the mode or type of presentation, pathology and investigative practice have been examined. Seventy‐six patients required surgical intervention either electively or as an emergency and these cases have been considered in detail.The surgical group included 44 men and 32 women; 21 patients presented for elective resection, and, 55 patients underwent surgery during their emergency admission. in the emergency group, 20 laparotomies were performed for pericolic/pelvic abscesses, five for small/large bowel obstruction, 30 for peritonitis and only one laparotomy was performed for haemonhage.The mortality for the entire group was 4% with all deaths occumng in the acute diverticulitis group. Three deaths followed emergency surgery and a further five patients died without coming to surgery, the diagnosis of acute diverticulitis being made only at post‐mortem.Overall, 44% of cases of acute diverticulitis underwent emergency surgery and a further 6% required surgery over the next 1–5 years.Resectional surgery was practised widely in the emergency group (the most common being Hartmann's operation). Less radical surgery is also preferred for localized sepsis in selected cases. The mortality was confined to patients who did not undergo resection of the septic focus.The elective group (24 patients) usually presented as a result of stricture, or chronic symptoms, and these patients generally did well with elective resection. The group of patients presenting with colonic bleeding behaved in a very benign manner. There was no mortality and only one patient required emergency surgery for

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00982.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Results of treatment of 70 patients hospitalized with acute diverticulitis were analysed to determine the value of early contrast enema in management. A water‐soluble enema done during the first week of hospitalization in 48 patients showed diverticulosis with spasm (30). a leak or peridiverticulitis (16) and a normal study (two). No complications were caused by the study. Forty patients improved on medical therapy, hut four relapsed after discharge. Thirty‐four (49%) patients had urgent operation during hospitalization for the acute episode of diverticulitis. Findings on contrast enema correlated with the need for surgery during the acute phase: 13 of 16 with peridiverticulitis or a leak compared with three of 30 with diverticulosidspasm (P<0.001). Operations performed were: sigmoid resection and primary anastomosis (17) with covering colostomy (five), Hartmann's operation (eight), colostomy and/or drainage (seven). right hemicolectomy (two). Findings at surgery were: abscess (15), phlegmon (12), peritonitis (five) and colovesical fistula (two). It is concluded that early contrast enemas of the distal colon done with appropriate precautions are useful in confirming the diagnosis of diverticular disease: only two of 48 studies were falsely negative. A pericolic extravasation (as opposed to a small sinus tract) or abscess usually indicates need for operation, whereas the finding of diverticulosidspasm suggests a favourable outcome of conservative managem

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00983.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Experience with gastrointestinal surgical conditions in 154 consecutive aneurysm operations at St Vincent's Hospital, Sydney, over 5 years (1982–86) is reported.Seventeen patients (11%) had coincidental gallstones, and six patients had other gastrointestinal conditions. Postoperative gastrointestinal complications occurred in eight patients. The overall in‐hospital mortality rate was 7.8%. Four of the 12 deaths were associated with gastrointestinal problems, but these complications first developed after aneurysm surgery in three patients and could not have been avoided by a concurrent operation.The management of gastrointestinal pathology in association with the treatment of abdominal aneurysm is reviewed. The coincidence of these disorders is not sufficiently frequent to allow valid comment on the probability of successful outcomes, but the risks posed by surgically untreated gastrointestinal conditions are low, so that secondary gastrointestinal procedures should be avoided in most aneurysm operati

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00984.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

The incidence of distal ischaemia following aortic reconstruction may be as high as 25%, despite the use of systemic heparin. As anticoagulation may be associated with excessive operative blood loss, a retrospective study was performed to assess the prevalence of these problems, in a consecutive series, during a 30‐month period. Evaluation of reconstruction was possible in 161 patients with aneurysm and 38 patients with occlusive disease. The incidence of vessel occlusion was 21% in the occlusive and 4% in the aneurysm group (P<0.05). Four of seven patients who had major vessel occlusion had serious complications. and there were two resultant deaths. These problems occurred despite the administration of heparin. Blood loss and operating time were quantitated in the patients who had resection for aortic aneurysm. Both were significantly longer in patients who received heparin (P<0.05) and the differences were maintained when patients were stratified according to increments in dose or operating time, and according to whether woven tube or bifurcation grafts were performed.It was concluded that aneurysm surgery, in the absence of distal occlusive disease, could be safely performed without the use of systemic heparin, but surgery for occlusive disease still requires heparinizatio

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00985.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Four patients with five severely traumatized lower legs but preserved feet were treated with fillet flaps from the foot to cover an elective, below knee amputation stump. The posterior tibial neurovascular bundle nourished and innervated this flap. While the posterior tibial artery and vein may be cut and re‐anastomosed to prevent kinking and occlusion, the posterior tibial nerve should always be kept in continuity to maintain the quality of sensation to this flap. Four flaps survived and one necrosed secondary to venous insufficiency. Due to its innervation and the unique qualities of heel skin, the flap is very durable and has endweight‐bearing capabilities. This has permitted the fitting of an endweight‐bearing, total contact, fully extended, below knee prosthesis that appears to offer significant improvement in ease of use and normality of gait pattern over standard patellar tendon‐bearing pro

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1988.tb00986.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY