摘要:

SummaryA histological study of the skin of 50 patients is presented comparing the findings in exposed and unexposed regions and relating the changes seen to age and exposure.The unexposed skin does not alter significantly in structure with age. The different appearance of the aged skin in unexposed areas is due to alterations in physical properties for which there is no matching alteration in morphology.The exposed skin shows changes predominantly in the dermis. These are described as “basophilic degeneration of collagen or “elastotic degeneration of collagen, which are synonymous with “senile elastosis.It is suggested that “collagen degeneration is a more suitable term than elastosis.It is found that the changes occur only on exposed regions and should be termed “solar degeneration as they are not primarily due to age.The factors influencing the development of solar collagen degeneration are as follows:(a) The fair skinned lightly pigmented patient is most susceptible and despite prolonged exposure does not develop satisfactory protective pigmentation. Heavily pigmented skin is protected as evidenced by the lack of collagen degeneration in dark skinned people and particularly in the aboriginal.(b) The degree of collagen degeneration corresponds well with the degree of exposure.(c) As age increases the degree of collagen degeneration is greater. However, this is proportional to the amount of exposure rather than to the age.(d) Sex: Men are affected more than women but this is related to increased exposure rather than to a variable susceptibility.The changes seen microscopically correlate well with the macroscopic appearance of the skin and explain the difference between the exposed and covered areas.These changes are responsible for the prematurely aged appearance of people exposed to the elements who are not heavily pigmented.A warning note is sounded in relationship to the ill effects of over exposure to the sun in fair skinned people. The price that sunlovers must pay is at least a prematurely aged appearance. The possible relationship between solar collagen degeneration and skin cancer will be discussed subsequently. Prevention of solar collagen degeneration by limitation of exposure in susceptible individuals i

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04351.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

摘要:

Summary1. A rase of congenital neuroblastonia is reported.2. Forty‐five other cases reported since 19·10 are reviewed.3. Twenty‐six cases (56 per cent.) survived fifteen months or longer without evidence of metastases.4. Of 14 cases arising apart from the adrenals, 13 survived.5. The 10 cases which were both extra‐adrenal and extra‐abdominal all

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04352.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

摘要:

SummaryFour cases of carcinoma of the sigmoid colon and rectum are described in each of which a metastasis was present in the anal region. It is concluded that in at least three of these cases the metastasis was due to surface implantation of fragments of the tumour. The diagnosis and the choice of operation in these cases is discussed.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04353.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04354.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04355.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04356.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

摘要:

Summary1. Intestinal obstruction of a purely functional nature can occur in newborn babies, particularly when premature.2. Previous accounts of the condition are reviewed, and a further 8 cases described.3. Differential diagnosis from organic obstruction is frequently difficult, but is important, as operation is to be avoided if possible. For this reason the passage of a rectal tube and the use of enemas should always precede the decision to operate on an obstructed baby.4. Conservative treatment is effective in tiding many of these infants over the obstructive phase and surgery has nothing to offer beyond exclusion of organic disease. Those babies that do survive show no evidence of any residual defect.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04357.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04358.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

摘要:

SummaryA 46‐year‐old woman had a well differentiated squamous cell carcinoma of the hreast excised. This tumour was not attached to skin, there was no associated adenocarcinorna, and it had metastasized to axillary nodes as squamous cell carcinoma.She remains well seven and one‐half years following operation.This is thought to be an authentic example of a rare neoplasm. Despite the rarity of the cmndition its existence should be remembered in the differential diagnosis of a lump in the b

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04359.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY

摘要:

Summary1. A series of 40 reconstructive operations on 36 patients for aorto‐iliac stenosis is presented. The stenotic lesions were divided into 2 groups:(a) Liriche syndrome (15);(b) isolated stenotic lesions elsewhere in the aorto‐iliac system (21).The differential diagnosis of these 2 groups on clinical grounds has been discussed.2. A follow‐up of the 40 operations has been performed over a period of six years. Twenty‐four of these operations were endarterectomies while the remaining 16 were arterial grafts. Only 50 per cent. of the grafts are patent at the present time while 92 per cent. of endarterectomies are working. In our hands the results of the latter operation are so superior that we tend to perform it in preference to grafting, where possible.3. The mortality rate (3 to 5 per cent.) for these operations is surprisingly good considering the magnitude of some of these procedures and the fact that often the patients are not first‐class operative risks. However, post‐operative complications have been numerous and include pneumonia (6), pulmonary embolus (4), ileus and burst abdomen (3), incisional hernia (1), adhesive obstruction (2) and superior mesenteric artery thrombosis (1).A transverse subumbilical incision has been used in the last 10 cases and none of these patients has ruptured their wounds, This incision gives a good exposure and appears to heal more securely than paramedian incisions.4. The symptom of impotence in cases of Liriche syndrome has been investigated. In this series 4 out of 10 patients (40 per cent.) questioned complained of either partial or complete importence. This figure is roughly similar to other published series. To our surprise only one of these improved following operation, in otherwise successful results. Inaddition, 2 of the other patients who did not complain of impotence before operation developed this symptom afterwards.Although impotence in Leriche syndrome may be due to inadequate blood supply to the pelvis, its incidence after operation suggests this may be due to disruption of the pelvicnerve plexus a

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1965.tb04360.x

出版商:Blackwell Publishing Ltd    

年代:1965

数据来源: WILEY