ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06152.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06153.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The plain X‐rays and CT scans of 23 cases of thoracolumbar and 18 cases of lower (below C2) spinal compression fractures were compared. A new picture of the fracture pathology has emerged as several features consistently appeared and are described: a midline or slightly oblique split of the vetebral body; posterolateral fractures of the body in the region of the developmental neurocentral joint; fragments of the body displaced backwards into the canal at the level of the pedicles; oblique laminal fractures; and separation of the zygapo‐physeal rim in thoracolumbar fractures. With this more complete picture of the bony injury, in particular canal encroachment, a new method of anterolateral canal decompression has been tried and is descri

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06154.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The experience with cortical somatosensory evoked potential (SEP) recording during 13 cases of spinal neurological surgery is described. Good quality cortical SEPs were obtained in eight patients with a variety of intradural and extradural spinal disorders. The short latency components of these waveforms were stable during anaesthesia with nitrous oxide, 0.5% halothane and fentanyl. Fluctuations in signal amplitude were, however, common. In the one patient in whom the cortical SEP waveform was distorted intra‐operatively, there was an increased neurological deficit. In one normal and four patients with impairment of dorsal column function, no intra‐operative cortial SEP was recorded. In these five patients spinal SEPs were recorded rostral to the level of spinal disease. Monitoring spinal cord function using cortical SEPs can provide useful neuro‐physiological information, however, there are limitations to its utility. These relate to difficulties in signal acquisition, the low signal amplitude, attenuation of the signal during intramedullary surgery and uncertainties in signal interpretation. All these problems are exacerbated if the patient has a pre‐operative clinical somatosensory deficit. Although most of these problems can be overcome using spinal SEP monitoring, intraoperative SEP recordings are not an infallible guide to spinal cord integrity since they reflect the functional status of only the dorsal column‐medical lemniscu

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06155.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

A Brindley‐Finetech sacral anterior root stimulator has been placed intradurally in the spinal canal around the S2, 3, 4 nerve roots in six paraplegics at the Burwood Spinal Injuries Unit, Christchurch, New Zealand. The apparatus developed by Professor G. S. Brindley and the Medical Research Council in London, UK, has proved very useful in driving micturition, in achieving a dry device‐free interval between electromicturitions, in reducing the incidence of urinary tract infections, and in some males in achieving a sustained erection. The clinical results are presented with a urodynamic analysis of the outc

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06156.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

A series of 131 tumours of the parotid was reviewed retrospectively to ascertain the value of clinical features in distinguishing between malignant and benign tumours. The overall proportion of malignancy in this group of tumours was 17% (23 tumours). It was found that sex, age, size, duration of symptoms, and history of rapid enlargement were non‐contributory to a diagnosis of malignancy, while the presence of facial nerve paralysis, skin infiltration or ulceration, and metastatic neck nodes were found only in patients with malignant tumours. A history of pain, hardness, and fixity, found in 30‐50% of parotid cancers, were significant indicatiors of malignancy. As the yield of routine frozen section examination on all resected parotid tumours is low, it is recommended that if resources are limited, the examination be reserved for tumours highly suspicious of being malign

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06157.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Over an 18 month period, 50 ‘high risk’ patients with solitary or dominant cold thyroid nodules on 99m Tc‐pertechnetate scanning, have undergone fine needle aspiration biopsy cytology (ABC) under general anaesthetic prior to thyroidectomy. Histological malignancy was confirmed in only four patients (8%). Cytological malignancy was suspected or confirmed in six patients, each having a false positive rate of 4%. There were no false negative reports. Ultrasonography, performed pre‐operatively in 37 of the patients, did not significantly add to the overall patient management. ABC appears to be safe, simple and sufficiently accurate to incorporate its use routinely in the pre‐operative assessment of thyroi

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06158.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Cervical lymph node biopsy is a fairly common surgical procedure. The diagnostic yield, however, varies in different centres and in different series depending on the vigour of the screening procedure, the surgical policy adopted and the surgical techniques employed. A surgical audit of the diagnostic yield of 203 lymph node biopsies was made and the results are discussed especially in relation to asymptomatic lymphadenopathy, infective lymphadenitis and metastatic nodes. Comments are also made as to how a better diagnostic yield could be obtained through more meticulous handling of the tissue.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06159.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Over the 10 year period 1974‐1983, 91 cases of liver abscess presented to the major teaching hospitals in Perth, Western Australia. Amoebic liver abscess (ALA) accounted for 37 (or 41%) of these cases, an incidence inflated by Perth's proximity to south‐east Asia where amoebiasis is endemic. This frequent recent history of contact, the availability of sensitive and specific diagnostic serology and a clinical presentation usually suggesting pathology in the right upper quadrant, accounted for the consistently short delay in diagnosis of ALA. There were no deaths from ALA and a low incidence of complications such as secondary infection or rupture into the thorax. On the other hand, pyogenic liver abscess (PLA) commonly presented in a more non‐specific manner and in an older age group, contributing to a long delay in diagnosis. Despite improvements in liver imaging techniques and advances in antibiotic and general supportive therapy, mortality for PLA remains high, 20% in this series. Fatal PLA was associated with multiple abscesses not amenable to drainage, increasing age, delay in diagnosis and the presence of septic

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06160.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Multiple occlusions of central venous catheters occurred in four patients who were receiving total parenteral nutrition (TPN). Misformulation of bulk prepared TPN solution caused temperature‐dependent precipitation of calcium phosphate within the catheter during infusio

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1986.tb06161.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY