ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05951.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Britain has remained the country most favoured by Australian and New Zealand surgeons for overseas training. Post‐fellowship training in Britain is advantageous in both service and research posts. Increase in personal operative experience, and the development of a special interest within general surgery are facilitated. Exchanges of surgical trainees between Australasian and British programmes can also be mutually advantageous, particularly during advanced training. College regulations and accreditation of surgical programmes in each country should remain sufficiently flexible to facilitate such exchange

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05952.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Despite the lack of precise knowledge as to its exact mechanism of causation, acute pancreatitis continues to engage the clinician's attention. The world medical literature is replete with publications on the subject and the numerous Australian studies attest to the continuing clinical interest (Hennessy, 1965; Bennett and Jepson, 1966; Kune, 1968; Barraclough and Coupland, 1972; Battersby and Chapuis, 1977 and Reid and Kune, 1978). The majority of these reviews concentrate on the supposed aetiology and clinical features of acute pancreatitis and cover well trodden ground. It is the purpose of this paper to review the problems in the diagnosis and management of acute pancreatitis in the light of present knowledge and to relate these to 494 patients with acute pancreatitis admitted to St Vincent's Hospital, Melbourne, during the period 1968 to 1979. The diagnosis of acute pancreatitis in these 494 cases was made at operation, autopsy or by the demonstration of an elevation in the serum amylase above 1200 International units (I.U.) per litre in patients with compatible symptoms and signs.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05953.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Myocardial metabolic, structural and functional preservation were evaluated in 44 patients who underwent open heart surgery under cardiopulmonary bypass, potassium cardioplegia and topical hypothermia. The duration of cardiac arrest varied from 14 to 87 minutes. Myocardial high‐energy phosphates were not only adequately preserved but actually exceeded the control values during periods of cardiac arrest. Glycogen levels were decreased moderately and one to three fold increases in lactate/pyruvate ratios were detected. Myocardial ultrastructure was well preserved. Postoperative clinical recovery of the patients was excellent. The only patient who died from a low output syndrome showed no evidence of myocardial damage. The results of this study serve to illustrate the beneficial effects of potassium cardioplegia and topical hypothermia on myocardial preservation during prolonged periods of ischaemic cardiac arrest, as used for the correction of congenital cardiac lesion

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05954.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

This paper reports a case of recurrent septic pulmonary emboli resulting from bacterial endocarditis on a ventricular septal defect. This was managed by the removal of vegetations, resection of the septal leaflet of the tricuspid valve, closure of the ventricular septal defect, and pulmonary embolectomy. The literature regarding the incidence and mortality of bacterial endocarditis on ventricular septal defects, and the management of the infected tricuspid valve, Is reviewed. The patient remains well two and a half years after surgery.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05955.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Major hepatic resections can now be performed with much greater safety than formerly. This is largely a consequence of improved surgical and anaesthetic techniques, which have in turn resulted from better understanding of the anatomy, physiology and biochemistry of the liver. The treatment of liver tumours by resection must be reappraised in the light of these advances. This paper reports twelve patients who have undergone major hepatic resection for neoplasm at the Royal Prince Alfred Hospital over a ten‐year period. The current indications for such surgery in the treatment of benign and malignant liver tumours are reviewed, and the results discusse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05956.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

In this controlled trial we investigated the effect of an anabolic steroid, in terms of the changes in body composition that occurred in ill surgical patients requiring intravenous nutrition. Glucose was the sole non‐protein energy source. The study was conducted over a 14‐day study period in two comparable groups of 13 patients. The changes in body weight, fat, protein and water were measured. The control group received a nutrient solution of hypertonic dextrose and amino acids (44.8 ± 8.2 kcal/kg/day), and the comparative group received the same solution (44.3 ± 5.2 kcal/kg/day) and 100 mg of an intramuscular injection of nandrolone decanoate at the commencement of the study and again one week later. Over the two‐week study period both groups gained body weight. In the controls this was composed of fat (0.4 kg) and water 1.5 kg). In the anabolic steroid group, weight gain was mainly water, and fat gain did not occur. Neither group gained body protein. Diuretic therapy was required more often (21 patient days compared with 5 patient days; p>0.001) in the anabolic steroid group to control excessive water retention. Our study has shown no benefit from an anabolic steroid when given in combination with a 14‐day course of intravenous nutrition. Water retention was more of a problem with thi

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05957.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Forty‐two cases of colorectal injury occurring over a five‐year period at the Princess Alexandra Hospital are described. The ratio of penetrating trauma to blunt trauma was approximately 2:1. There are a number of alternative methods of surgical management available. The indications and problems associated with each are discussed. Surgeons should match the appropriate treatment to the individual problem, with the emphasis on conservat

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05958.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Endoscopic sphincterotomy was performed in 53 patients with biliary tract disease who were considered to be at high risk from conventional surgical procedures. Forty‐five patients had choledocholithiasis, while eight had miscellaneous disorders including carcinoma, stenosis of the papilla, and postoperative biliary fistulae. Forty‐three of 45 patients with choledocholithiasis have been free of symptoms since the procedure, and most have had repeat retrograde cholangiography confirming the absence of bile duct stones. Endoscopic sphincterotomy is a safe and effective procedure in selected high‐risk patients, particularly those with choledocholithiasis after cholecyste

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05959.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Primary bladder stones are described as occurring in aboriginal children from native reserves. Here breast feeding is supplemented early in life with white flour and little else. A comparison is made between this diet and that of children in endemic bladder stone regions, and reasons are advanced for the formation of these stones, with biochemical evidence to support the thesis that ammonium acid urate precipitation is the initiating factor.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb05960.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY