ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07450.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.tb07451.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.tb07452.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

The clinical stage at presentation of 280 women with histologically proven breast cancer is reviewed over a 25 year time span from 1962 to 1987. The data from 240 unscreened patients, including 87 women from the period 1962 to 1963. 103 women from 1981 to 1982, and 50 women from 1986 to 1987 demonstrate a chronologically based improvement in the stage of disease at presentation over the 25 years. Specifically, over that period, there was a fall in the mean tumour diameter, a reduction in the proportion of patients with involved axillary nodes, and a greater percentage of patients with Stages I and II disease. A reduction in the symptomatic period was also noted over this time, and a direct relationship was found between the duration of symptoms and tumour size, nodal status and overall stage of disease. A subsequent comparison with the staging data from 40 women with breast cancer detected at a breast screening clinic (1985–87) shows that significant further advances in the earlier diagnosis of breast cancer can be achieved. Mammographic breast screening centres represent the best‐known means of early breast cancer detection, and thus may hold the key to reducing breast cancer mortal

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07453.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Tamoxifen is widely used in the management of breast cancer, including long‐term use in women with early disease to reduce recurrence and mortality. Although remarkably side‐effect free, concern has been expressed that its anti‐oestrogen activity may extend to lipid metabolism and so result in the premature development of coronary heart disease. In a study of breast cancer patients, those taking Tamoxifen tended to have lower cholesterol concentrations (predominantly low‐density lipoprotein cholesterol) and raised triglyceride concentrations. These changes are likely to be protective for coronary heart disease, suggesting Tamoxifen has an oestrogenic rather than anti‐oestrogenic effect as regards lipid m

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07454.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

One hundred operations for Crohn's disease have been reviewed. The 100 procedures were performed on 54 patients. Thirty‐four patients had had a single operation, and 20 patients had had the other 66 operations. The patients were classified into four categories: small intestinal disease (n = 17), jejuno‐ileocolic (n = 7). colonic (n = 5) and classical ileocolic (n = 25). These categories had differing disease severity, symptotmatology and re‐operation rates. The distribution of the disease in Northern New Zealand seems similar to that elsewhere. Whereas a small number of patients may have a large number of complications and recurrences and a prolonged stay in hospital, the majority of patients can have safe and effective surgery for Crohn's disease. This is particularly true for patients with ileocolic disease and who have a limited ileocolic rese

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07455.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

An audit of 18 patients whom the author managed by abdominal colectomy, rectal mucosectomy and ileo‐anal reservoir anastomosis was undertaken to assess the resulting quality of life. Sixteen patients had ulcerative colitis and two had familial adenomatous polyposis. In each case. a temporary loop ileostomy was performed at the time of reservoir construction. The minimum time since stoma closure was 12 months. The mean number of daily evacuations after stoma closure was eight (range: 4–15). Six patients usually had daytime soiling and eight overnight soiling. Nine patients always wore a perincal pad. Six patients had significant urgency of defecation and 15 patients took medication to reduce bowel frequency. Anorectal problems were noted by all but one of the 18 patients. However, of 14 patients who had lost time from work prior to operation. 12 have returned to uninterrupted employment. Of 11 patients who were unable to travel because of colitis symptoms, eight have no restrictions postoperatively. Twelve patients noted that their diets were more varied since surgery. Of fourteen patients who had restricted sex lives because of colitis symptoms. 11 were subsequently not restricted. On the other hand, during the 3 months the ileostoiny was required, scxual activity was restricted in all but one patient. Other aspects of life also restricted by the stonia were sporting activity (14) and social life (15). Improvement followed stoma closure. Overall. the patients graded the success of the reservoir surgery as excellent (7), very good (3), good (2), satisfactory (4), poor (0), or prefer ileostomy (2). Thirteen patients believed their total lifestyle had improved. The survey suggests that, although not perfect, restorative proctocolectomy is a reasonable option for patients who require surgery for ulcerative colitis or adenomatous polypo

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07456.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Sixteen otherwise healthy women undergoing cholecystectomy were randomized to receive postoperative analgesia either by continuous infusion of papavereturn (n= 8), or by continuous interpleural infusion of bupivacaine (n= 8). Postoperative pain was assessed by linear analogue and ventilatory capacity. Changes in body protein were measured byin vivoneutron activation analysis. Clinical course was also noted. Pain scores were significantly lower in the interpleural group over the first 48 h (P<0.02). Ventilatory capacity was also significantly better for the first 24 h (P<0.025). Thet‐e was no evidence of shortened postoperative ileus: hospital stay and postoperative fatigue were similar for the two groups. Weight and protein losses over a 2 week period were similar in the two groups. It is concluded that the apparent advantages in patient cotiifort and mobility offered by interpleural infusion are most marked in the first 48 h postoperatively. with an advantage in ventilatory capacity over the first 24

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07457.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

A retrospective analysis of all primary upper urinary tract tumours (300) filed in the pathology department of a regional hospital in Hong Kong during 1972–87 showed that renal cell carcinoma (143) was the commonest malignant tumour. Transitional cell carcinoma of the renal pelvis (62) was the next most frequent. Fibromas, which occurred as frequently as angiomyolipomas (28) and outnumbered tumours such as squamous cell carcinoma (13) and nephroblastoma (12), were little clinical significance since they were invariably incidental findings. Nephrectomies were seldom performed for kidneys involved in secondary malignancies. Rare tumours encountered were adenocarcinonia of the renal pelvis, leiomyosarcoma, malignant fibrous histiocytoma, adenoma, oncocytoma, mesoblastic nephroma and multilocular cystic nephroma. Angiomyolipomas were responsible for most cases of surgical emergenc

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1990.tb07458.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.tb07459.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY