ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01229.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

In a group of 322 patients with adenocarcinoma of the stomach, 158 underwent resection. The only 5 year survivors came from the resection group. Increasing age, lymph node metastases and increasing depth of invasion of the gastric wall were all adverse prognostic features. There wax a high incidence (19%) of resected patients who had suture line involvement. In spite of this there were 5 year survivors among those patients with suture line involvement and also those with lymph node involvement. The judicious implementation of an aggressive resection policy will give patients with favourable tumours the chance of a 5 year cure without involving patients with widespread neoplasm in radical surgery. Patients who had undergone previous gastric surgery for any cause had an extremely bad prognosis. Improvement in 5 year survival rates in patients undergoing resection for gastric cancer could be attributed to the increase in the number of patients with early gastric cancer.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01230.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A review was conducted of children with intussusception admitted to the royal children's hospital over a 16 year period: of 630 episodes of intussusception, 28 represented recurrences (4.4%); 10 of these occurred in children aged 2 years or over. Duration of symptoms and the incidence of an incorrect initial diagnosis were markedly reduced with recurrence. The clinical presentation was similar to (he first episode apart from rectal bleeding which was less common, reflecting the shorter history. Sixteen barium enemas were performed, of which 10 were successful. There were 18 operations with eight resections: seven for localized lesions and one for failure of manual reduction in a patient with an inverted meckel's diverticulum. Barium reduction for recurrence should not be attempted in children over 2 years of age in whom no laparotomy was performed for their first episode, for most second recurrences, or in multiple polyposis.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01231.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

This is a retrospective study of 91 patients treated for intussusception between 1982 and 1984. Criteria for inclusion in the study were the finding of a classical radiological appearance on barium enema examination or the presence of an intussusception at operation. The clinical features are described. A protocol of management first reported in 1983 was followed with 90 of 91 patients submitted to a diagnostic and/or therapeutic barium enema. As a result of recent experience, the protocol has been modified in selected patients at the discretion of the surgeon and the radiologist. A success rate of barium enema reduction of 78% was achieved, which is higher than in previous princess margaret hospital studies; there was recurrence of the intussusception in 12 patients following hydrostatic reduction. Further barium enema reduction was successful in 11 and operation in one. There was no mortality and minimal morbidity.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01232.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A retrospective study was undertaken of 124 patients admitted with gunshot and stab wounds between january 1980 and the end of june 1985. The present series found an almost equal number of gunshot wounds (65) and stabbings (59). With an increasing incidence. The patients fell heavily into the categories of being male (88.7%). In their twenties (42%) and having consumed alcohol (52% when documented). There were 77 cases of assault, with 5o of these being caused by persons known to the victim, whilst violent crimes and prison riots accounted for the rest. The majority of injuries occurred outside normal working hours, with 62% arriving at the hospital between 8 pm and 8 am. There were 14 deaths (11.3%), usually within the first 4h. With all but one occurring in the first 24h. Gunshot wounds resulted in a higher mortality rate (16.9% cf. 5%) and longer hospital stay.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01233.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Metastatic disease in the parotid gland and its associated lymph nodes is generally thought to be uncommon. A review of 121 cases was undertaken to study the incidence, histology and prognosis of secondary malignancy in the parotid region. Forty‐two per cent of the cases were secondary malignancies. The majority of these were squamous cell carcinoma, and in this group the prognosis was poo

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01234.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

A review of arterial embolism to upper and lower limbs from 1961 to 1985. During this period 253 patients were treated for 269 episodes of embolus at the princess alexandra hospital. The period was divided into 5 year intervals and analysis showed significantly increasing age for the population over this period. Similarly a decreasing mortality rate was noted during this period although limb salvage did nol change after the initial 5 year period. There was a rising incidence of atherosclerotic ischaemic heart disease and a decreasing incidence of rheumatic heart disease. The overall mortality rate was 15.6% while the overall amputation rate was 8.2%. Factors significantly related to survival were acute myocardial infarction and level of occlusion. Factors significantly relating to morbidity were pre‐operative heparin administration and performance of completion angiography. The performance of completion angiography was shown to improve the result from embolectomy without having adverse influence on the mortality rate. The results of this review indicate that pre‐operative heparinization, the performance of completion angiography, and the flexibility to explore multiple levels of the limb circulation, are essential factors in the management of peripheral arterial embol

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01235.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Sixty patients presenting with acute urinary retention were randomly allocated to treatment with either suprapubic or urethral catheters. An initial specimen of urine was obtained for bacteriological culture and organism count. Subsequently, repeat specimens of urine were obtained at intervals of 2 days until the catheter was removed. The results of these cultures showed that suprapubic catheters caused less urinary tract infection (p<0.05). In addition, suprapubic catheters were more comfortable for the patients, easier to manage and more cost‐effective. In patients with suprapubic catheters, their ability to void could be assessed prior to removal of the catheter, thus avoiding the need for recatheterization. It was concluded that patients presenting with acute urinary retention should be routinely treated by drainage using suprapubic catheter

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01236.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

The buschke‐lowenstein tumour of the penis is a rare neoplasm of probable viral origin. It is locally destructive but does not appear to metastasize. The three cases reported illustrate the clinical features and the surgical treatmen

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01237.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY

摘要:

Energy and protein metabolism in septic and trauma patients has been extensively studied over the past 30 years. Despite this, a number of inconsistencies are present in the literature and it is difficult to formulate a clear global picture of this complex series of metabolic events. Conclusions from human studies have often been hampered by the utilization of small numbers of patients, and data from animal models of sepsis or trauma are often difficult to interpret. Over the past 5 years, the authors have performed a series of isotopic infusions in normal volunteers, and in patients with either sepsis or trauma, in order to gain a clearer understanding of energy and protein metabolism in severely stressed patients. This review summarizes the findings.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1987.tb01238.x

出版商:Blackwell Publishing Ltd    

年代:1987

数据来源: WILEY