摘要:

Experience with vascular trauma over a nine month period is presented. Not all cases of arterial injury are obvious on initial presentation. Preoperative arteriography may be helpful but should not delay arterial reconstruction. Fractures should be stabilised prior to arterial repair. Intra‐operative arteriography may be useful, and fasciotomy should be used liberally in all cases of established ischaemia. Serious associated injuries are common and may determine the ultimate outcom

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04958.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

During the past 51/2years, thirty consecutive and unselected patients who bled from oesophageal varices underwent distal lienorenal shunt surgery. Eight deaths occurred in the immediate postoperative period. Three of nine emergency patients died because of continued bleeding and, of the five elective patients who died, four were largely the result of technical problems encountered at surgery. In the immediate postoperative period variceal bleeding recurred in five of eight emergency patients despite shunt patency. This did not occur in the elective group. Shunt blockage was relatively common compared to that following conventional porta‐systemic shunt surgery; being documented in five of the 24 patients in whom patency was assessed. No clinical, biochemical or histological criteria were identified as predictors of outcome. In particular, the presence of preoperative ascites gave no indication of postoperative problems. However, if ascites developed in the immediate postoperative period, it was a major management problem in 50% of patients. In conclusion, the distal lienorenal shunt has a high perioperative mortality, is commonly complicated by shunt thrombosis and, in the emergency situation, often fails to control bleeding. The technical difficulties encountered at surgery appear largely responsible for the early morbidity and mortalit

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04959.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

A cytochemical section bioassay has been used to assess the carbonic anhydrase activity, induced by the gastrin peptides G13, G17 and G34 (concentration 5.0‐0.005 pg/ml), in guinea pig parietal cells. When the mean integrated density ot the induced response x 100, was plotted against the concentration of the gastrin peptide used, a graded dose response and a positive linear correlation was found for G13 and G17. These responses were similar. G34 did not produce a linear dose response in the concentration range 5.0‐0.005 pg/ml, but an higher overall carbonic anhydrase activity was observed than with G13 and

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04960.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Oestrogen receptor (ER) measurements in metastatic and primary tumours from patients with breast cancer have been correlated with the objective tumour response to treatment with aminoglutethimide (24 patients) or tamoxifen (39 patients). The rate of response in patients with ER‐positive tumours (aminoglutethimide 69%, tamoxifen 70%) was significantly greater than in those with ER‐negative tumours (aminoglutethimide 9%, tamoxifen 10%). Five of six patients showing an objective response to tamoxifen treatment responded later to aminoglutethimide, whereas only two of 12 patients who had not responded to tamoxifen responded later to aminoglutethimide. Toxicity rates were low for tamoxifen (5%), and reasonably low with aminoglutethimide (20%). Because of the low toxicity of tamoxifen, this agent could reasonably be used in breast cancer regardless of the availability of tumour ER measurements. The use of aminoglutethimide could be based either on the presence of ER in the tumour or on the response to previous tamoxifen ther

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04961.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

A survey of 110 general surgeons was undertaken to assess their attitudes towards breast reconstruction following mastectomy. While the majority were in agreement in principle, evaluation of the various criticisms affecting their attitude showed a uniformity of concern over the possibility of masking local recurrences.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04962.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Fifty patients were admitted to a prospective controlled double blind trial for assessment of the effect of preoperative intramuscular cephazolin with oral metronidazole or placebo on the incidence of wound infection in patients requiring treatment by elective large intestinal resection. All patients were operated upon by one surgeon. After exclusion of two patients who died postoperatively 48 were analysed. No wound infection occurred In 22 patients receiving cephazolin with metronidazole. One (3.8%) infection developed in 26 patients receiving cephazolin with placebo. The difference did not attain statistical significance. Preoperative intramuscular cephazolin with or without metronidazole provides an effective and safe method of chemoprophylaxis for elective colorectal resection.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04963.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

We have examined the usefulness of a Silastic foam dressing in the management of open granulating wounds in 55 outpatients. It is an acceptable and comfortable dressing, which allows earlier discharge from hospital. The method of making the dressing, and the daily care of the wound are described. Improved wound care is achieved by providing two dressings, so that when one is in place the other is being thoroughly cleaned. This technique has been shown to reduce bacterial contamination of the wounds and to improve wound healing (p 0.02).

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04964.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

Four patients with colo‐enteric fistulae due to diverticular disease are presented. They represent 5% of 80 patients admitted for surgical treatment of diverticular disease. A long history of abdominal pain, diarrhoea and significant weight loss were prominent features. Barium enema X‐ray examination was not helpful in demonstrating the fistu

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04965.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The Hickman type right atrial catheter was used in 15 patients requiring chemotherapy, parenteral nutrition, and monitoring of various malignancies. The catheter was well tolerated, with an acceptable complication rate despite the compromised status of the recipients. Its use represents an important practical advance in the management of severely ill patients in whom repeated or continuous vascular access is required.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04966.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY

摘要:

The conventional osteotomy technique is inadequate in some rhinoplasties. A method of multiple osteotomies is described and evaluated, and the indications for it are given.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1981.tb04967.x

出版商:Blackwell Publishing Ltd    

年代:1981

数据来源: WILEY