The British journal of surgery
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A series of twenty-eight aneurysms of the popliteal artery is reviewed. The cases were collected from the records of two large hospitals each with a unit with a special interest in vascular surgery. ⋯ The majority of patients had symptoms and 7 lost a leg as a direct result of thrombosis or rupture. The results of treatment were best when saphenous vein was used to replace an uncomplicated aneurysm and, since the behaviour of aneurysms is unpredictable, we conclude that this is the treatment of choice.
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Comparative Study Clinical Trial Controlled Clinical Trial
Peroperative antibiotics in the prevention of chest infection following cardiac operations.
Seventy-nine patients about to undergo cardiac operations were randomly allocated to two treatment groups in an attempt to reduce postoperative chest infections. The group receiving a short peroperative course of cefamandole, an antibiotic effective against both the pneumococcus and Haemophilus influenzae, had a significantly lower postoperative chest infection rate than the group receiving a 3-day course of cephradine, an antibiotic previously chosen to prevent intracardiac infection during the operation. By selecting an appropriate antibiotic it is possible, using a short peroperative course, to reduce the postoperative chest infection rate in patients undergoing cardiac operations.
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A lung colony assay for clonogenic cells of human tumours in immune-suppressed mice is presented. The assay was used to determine the chemosensitivity of two malignant melanomas. One tumour reproduced the spectrum of chemosensitivity associated clinically with three cytotoxic agents. ⋯ An invesitgation of the importance of size as a determinant of response to radiotherapy demonstrated that 0.5-mm diameter tumour nodules were significantly more sensitive to irradiation than 2-cm diameter nodules. The hypoxic fraction of the larger tumours was 65 per cent, which is higher than that reported for experimental animal tumours or a human pancreatic tumour. This could be a factor in the clinical radioresistance of malignant melanoma.
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Comparative Study
A 10-year survey of large bowel carcinoma at Groote Schuur Hospital with particular reference to patients under 30 years of age.
In a 10-year survey of large bowel carcinoma at Groote Schuur Hospital 926 cases were studied retrospectively. A marked difference was seen in both the age of presentation and histological differentiation in two different racial groups. ⋯ Predisposing factors, symptomatology, treatment, pathology and prognosis are discussed. It is apparent that large bowel carcinoma in the young has a very poor prognosis.
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Two patients with strictures of the small intestine after blunt abdominal trauma are reported. In the first there were multiple severe injuries and the ileal stricture due to a mesenteric tear was not diagnosed until 6 weeks later. In the second an apparently minor injury was responsible for direct damage to the wall of the jejunum and a subsequent stricture.