摘要:

Summary1. Some modern trends in the treatment of carcinoma of the oesophagus are discussed.2. A personal case series of 170 patients with carcinoma of the oesophagus during theperiod 1945 to 1959 and a ten year series from the Royal Melbourne Hospital (1949–1958) are presented.Carcinoma arising in the stomach or gastric cardia are excluded but not those involving both pharynx and oesophagus.Brief reference is made to 32 cases who received radiotherapy at the Peter MacCallum Clinic over the same period 1949 to 1958.3. The advanced age and frailty of the patients are evidenced, and sex variations discussed in relationship to site.4. The intractability of many of the lesions is discussed in terms of local metastasis (63 per cent.), blood stream metastasis (15 per cent.) and advanced spread. Reference is made to double carcinoma and vagaries of spread and recurrence. A wide margin of resection is advised if cure be the objective.5. Views on the place of palliative and radical procedures are advanced in the light of the pathology, the distress of the patients cnd the grim outlook of the untreated disease.6. Palliatie measures discussed include intubation (with preference for plastic tubes), gadrostomy and jejunostomy (which are not favoured). short circuits, palliative resection and X‐ray therapy.7. Major surgical excisions were carried out in 68 of the personal case series; lowerthird 33, middle third 44 and upper third 39 with mortality 29 per cent. (15 per cent. lower third, 32.5 per cent. for the upper two‐thirds).8. On the basis of results obtained in Melbourne there does not appear to be any well‐established case for abandoning surgery for carcinomata of the upper two‐thirds of the oesophagus.9. A survey of these results together with others available from other countries suggests that the disease is grim indeed, but that surgery offers comfort and some distinct hope of lasti

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03091.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

摘要:

SummaryAn experience with cases of carcinoma of the pyriform fossa and hypopharyrix is reviewed. The need for awareness of early symptoms and thorough examination of patients with such suggestive symptoms is stressed.The uniformly bad results of carcinoma of the pyriform fossa are noted and suggestion, for the consideration of radical surgery in some of these cases is made. The problems associated with the management of carcinoma of the hypopharynx are discussed and the results of treatment of 9 cases are reviewed.Case histories of these 9 cases are given in some detail.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03092.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

摘要:

SummaryThe basic physiology of the output of the heart and the total body peripheral resistance and their relation to the blood pressure are reviewed together with their methods of estimation.The radio‐isotope dilution method of cardiac output determination is described in detail and the effects of thiopentone, “Presuren and halothane on cardiac output and peripheral resistance were studied in a few cases.The application of this method to the investigation of new anaesthetic agents, the causes of hypotension under anaesthesia and the management of hypotensive states appears Received for publication 15th October, 1959.In clinical practice, anaesthetists may use Starr's pulse‐pressure formulas to obtaina better indication of the direction and magnitude of the changes in the cardiac output under anaest

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03093.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

摘要:

SummaryA series of 34 cases of ulcerative colitis subjected to colectomy and ileorectal anastomosis has been reviewed.A good or satisfactory result was obtained in 18. In 8 cases there was a late severe recurrence of disease in the rectal stump. following an interval (on an average three years)in which in 6 the result had been good or satisfactory. In 5 of these latter it was necessary, because of the severity of the proctitis, to excise the rectum.It is concluded that those most likely to have the benefit of a good result following colectomy and ileorectal anastomosis are the young patients with short histories, in whomthe rectum is only mildly affected, and where at least 15 crns of rectal stump is left. Avery satisfactory scheme is a two stage procedure with colectomy and ileostomy as the first stage.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03094.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03095.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03096.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

摘要:

SummaryA case of carotid‐cavernous sinus fistula with ocular symptoms on the contralateral side is reported.Carotid ligation resulted in heniiplegia one and a half hours after ligation. This was relieved when the ligature was removed. Subsequently slow occlusion of the internal carotid by a clamp was carried out successfully.The importance of anoxic cerebral infarction as a sequel to internal carotid occlusion is discusse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03097.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

摘要:

SummaryFamilial polyposis is associated sometimes with an abnormal behaviour in certain other tissues. Osteomata, soft tissue tumours, sebaceous cysts and intra‐abdominal fibrous tissue masses may co‐exist with familial polyposis.A case is recorded in which a desmoid tumour appeared in the wound after surgical treatment of familial polyposis. This is the 17th case to be reported in the literature.Pathologically, the tumour appears to be histologically distinct. from palmar and plantar fibromatosis nor does it seem to be inflammatory in origin.Desmoid tumours in surgical incisions are rare but the number that have been reportedin familial polyposis seems to indicate that in this disease there is a special tendency. The desmoid tumour may or may not be associated with fibrous tissue masses and osteomas elsewhere. In the case reported here these were present. It is known that this latter abnormality is transmitted as a Mendelian dominant. The curious association with polyposis has suggested two closely linked genes, or a pleotropic gene; a more acceptable theory is that the mutant gene has but a single action many steps removed from any clinically obvious manifestations.Recurrence after removal is so common that it seems excision should be very wide, to avoid the involved fascia1 sheets. The prognosis of these desmoids has not been established and it is possible that removal is not essent

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03098.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

摘要:

SummaryThe clinical and physiological features of atrial septal defect are reviewed.The prognosis for patients with this defect is quite limited and ideally repair should be carried out before adult life.Associated anomalies that may occur are detailed and their assessment described.Surgery restores the circulation to normal and gives symptomatic improvement. Improvement may also be noted by patients with no spontaneous complaints.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03099.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY

摘要:

SummaryThe condition of occlusiorl of the anteriot tibial artery is described and illustrated by a case of embolism resulting in gangrene of the tissues of the anterior compartment, infection and ultimately in amputation. The related condition of the anterior tibial syndrome is mentioned. The early reccgnition of the condition is necessary, to employ a minorsurgical procedure which may offer some prospect of mitigating the effects of the ischaemia.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1960.tb03100.x

出版商:Blackwell Publishing Ltd    

年代:1960

数据来源: WILEY