摘要:

AbstractThe data from a previously reported large series (1067 cases) of insulin tumours of the pancreas have allowed study of the problem of management of so‐called ‚occult’︁ tumours. Of the occult tumours in the whole series, 54 per cent were situated in the head of the pancreas, as opposed to 26.5 per cent similarly located at the initial operation.Analysis of the records of 542 single benign beta‐cell adenomas showed no correlation between the size of the tumour and the duration of symptoms. There were 168 cases of single benign tumours which could not be located at the first operation, but which were cured at a subsequent operation. In 65 per cent of these cases the tumour could not be located at the subsequent operation and was only found after blind resection.These results indicate that the growth of these tumours is not regular and constant. They lend no support to the suggestion that if an insulin tumour cannot be located blind resection should be avoided in the hope that after 1‐2 years, during which symptoms can be controlled by diazoxide, the tumour is likely to he located at a second operation. It is concluded that if the tumour cannot be located the treatment likely to give the best results is progressive blind pancreatic resection from left to right, with careful examination of the excised specimen and frequent estimation of the blood sugar co

ISSN:0007-1323    

DOI:10.1002/bjs.1800610102

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractIntravenous glucose tolerance tests were performed in 18 patients before, during and after surgery. Glucose utilization was found to be significantly depressed during and after operation to a degree which increased with the severity of operation. Suppression of insulin secretion was observed during operation together with increased plasma cortisol levels and an increased urinary catecholamine excretion. It is suggested that a failure of cellular glucose utilization is the primary event in the metabolic response to injury which initiates cellular catabolism and urinary nitrogen loss.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610103

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA review of patients following a partial gastrectomy for benign peptic ulceration reveals very satisfactory symptomatic results. Minimal haematological and biochemical disturbances have been produced and all the patients with gastric ulcers were cured. The gastric resection has been limited to two‐thirds in all the cases.One hundred and ninety patients were included in the review, and of these, 99 underwent detailed haematological and biochemical investigation.Ninety per cent of the patients were graded as Visick I or II. There was a low incidence of severe vomiting (1.5 per cent), diarrhoea (1.5 per cent) and dumping (1.9 per cent)Anaemia was manifest only in males (18 per cent). Iron deficiency was present in both sexes and increased in severity with time. The deficiency has been readily corrected with oral iron. There was no macrocytic anaemia, 10 per cent of patients having subnormal serum vitamin B12levels. There was no folate deficiency.No biochemical abnormality was noted.Eight patients treated for duodenal ulcers developed recurrent ulcers but 6 of these followed Billroth I gastrectomy. Recurrence following a Poly a gastrectomy was 2 per cent. No gastric ulcer recurred.These findings justify treatment of both duodenal and gastric ulcers by partial gastrectomy.A modification of the Billroth I operation was used to overcome technical problems. Operation details are given and it is suggested that this operation is ideal for gastric ulce

ISSN:0007-1323    

DOI:10.1002/bjs.1800610104

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractOf 388 patients with carcinoma of the large bowel, 90 presented with obstruction, In this group 50 patients (56 per cent) were treated by a curative resection, 22 by primary resection and 28 by staged resection. The prognosis was considerably better after primary resection than after staged resection. Crude 5‐year survival figures are 50 and 25 per cent respectively. It is concluded that a prospective trial of immediate resection in the management of obstructing large bowel cancer seems justifie

ISSN:0007-1323    

DOI:10.1002/bjs.1800610105

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThe effect on skin flora of spreading 2 ml of blood over the hands after a 2‐minute disinfectant handwash and then wearing rubber gloves for an hour was assessed by a trial in which 6 volunteers used each of six preparations, once with blood and once, as a control experiment, with water on their hands. Bacterial counts of handwashings and of glove washings showed significant interference by blood with the effectiveness of povidone iodine detergent solution (Disadine). With a 3 per cent hexachlorophane detergent cream (Disfex) significant interference by blood was shown in bacterial counts of glove washings and a nearly significant interference was shown in counts of handwashings. There was no evidence of any interference by blood with the effectiveness of a 4 per cent chlorhexidine detergent solution (Hibiscrub) or a 3 per cent hexachlorophane liquid soap containing 0.3 per cent chlorocresol (Ster‐Z

ISSN:0007-1323    

DOI:10.1002/bjs.1800610106

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractPentagastrin is deamidated to pentagastrin acid by high‐speed supernatant preparations obtained from rat, dog and human liver. The product, which contains all the amino acids in the parent substance, is biologically inactive. Experiments with pentagastrin labelled with carbon 14 indicate that this reaction also occurs in intact dog

ISSN:0007-1323    

DOI:10.1002/bjs.1800610107

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA preparation was developed in the pig in which transhepatic samples could be taken, and the duration for which the pig liver would tolerate ischaemia was studied. Total occlusion of the hepatic artery, portal vein and inferior Venn cava was caused after studies of the effects of occlusion of the portal vein or the vena cava alone. Adequate splanchnic decompression was provided by a splenojugular bypass.Reversible changes were noted in the acid/base status and potassium levels after ischaemia. Aspartate transaminase (SGOT) levels rose and remained elevated during the hour of study following occlusion. Alkaline phosphatase and glucose levels changed but remained within normal laboratory limits, although there appeared to be a release of glucose from the hepatic veins after occlusion. Portal pressure increased reversibly after ischaemia and returned to normal within 1 hour. Bile flow ceased during inflow occlusion and resumed 15 minutes after the release of the clamps.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610108

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractThe feasibility of using a segmental auxiliary liver graft comprising some 40 per cent of the total liver mass fed by the renal vein rather than the portal vein is studied. An autotransplantation technique is described which has the advantage of excluding the problems associated with rejection. Two groups of dogs are investigated in one of which an orthotopically placed segment of liver is also retained. Data are presented which show that a heterotopically placed segment comprising only 40 per cent of the total liver mass can be transplanted heterotopically and in the absence of portal vein influence can maintain animals in good health for months. Furthermore, the presence of an orthotopically situated segment with a normal haemodynamic supply does not inhibit the function of a heterotopic one. The results suggest that in the absence or inhibition of the rejection mechanism heterotopically placed partial liver grafts can function well and be life‐supportin

ISSN:0007-1323    

DOI:10.1002/bjs.1800610109

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractA study has been made of 44 patients with venous insufficiency. Tape recordings of Doppler shift signals during reverse flow in the long saphenous vein have been subjected to frequency analysis to determine whether laminar or turbulent flow was present. Analysis of flow patterns along with evidence of calf muscle pump dysfunction enabled the patients to be classified into three groups:Group 1:Patients showing laminar reverse flow, minimal varices and minimal symptoms.Group 2:Patients with laminar reverse flow, minimal varices, severe symptoms and signs of calf pump dysfunction.Group 3:Patients with turbulent reverse flow, gross varices, negligible symptoms and no evidence of calf pump dysfunction.The relationship between the three groups and their possible prognoses are discussed.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610110

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY

摘要:

AbstractFour cases of inferior vena caval injury seen recently at the Accident Service of the Colombo General Hospital are reported. Three patients presented in shock, white 2 had active bleeding at the time of operation. Direct suture was successful in 3 cases. Methods of access to the various segments of the inferior vena cava are discussed together with a review of the literature.

ISSN:0007-1323    

DOI:10.1002/bjs.1800610111

出版商:John Wiley&Sons, Ltd.    

年代:1974

数据来源: WILEY