Cerebral revascularisation in stroke prophylaxis.

Abstract:

:Over 700 cerebral vascular operations have been undertaken on the Surgical Unit of St Bartholomew's Hospital, London, for stroke prophylaxis, the majority being carotid endarterectomies. One of the unique features of the latter procedure is the marked instability of postoperative blood pressure. The relation of this change to interference with carotid baroreceptor function was studied by per-operative carotid sinus nerve recording. It was possible to relate nerve activity to the postend-arterectomy changes in the mechanical properties of the vessel wall in the region of the carotid sinus. Postoperative hypotensive episodes could be reversed by the injection of local anaesthetic alongside the carotid sinus nerve through a cannula left in situ at operation.The complications of 425 carotid endarterectomies were analysed by computer and specific risk factors were found to be hypertension, the presence of contralateral internal carotid artery disease, and the presence of lower limb vascular disease. The carotid angiograms of 200 patients were studied with respect to the extent of the disease at the origin of the internal carotid arteries. The operative complication rate was found to be closely related to the severity of this disease, all severe complications occurring in patients with severe bilateral internal carotid artery stenosis or occlusion. This finding has led to the introduction of the term the ;reperfusion syndrome', and the mechanism of the complication is still under study.Seventy-nine extraintracranial revascularising procedures have been undertaken and this operation has been shown to carry a very low morbidity. The postoperative incidence of recurrent transitory ischaemic attacks (TIAs) and strokes is low, but the longest follow-up period is still only 4 years. The value of the procedure for TIAs and strokes is under study, as is its place in the treatment of patients with dementia.

journal_name

Ann R Coll Surg Engl

authors

Lumley JS

subject

Has Abstract

pub_date

1980-09-01 00:00:00

pages

335-43

issue

5

eissn

0035-8843

issn

1478-7083

journal_volume

62

pub_type

杂志文章
  • Emergency management of malignant acute left-sided colonic obstruction.

    abstract:INTRODUCTION:The management of acute left-sided colonic obstruction still remains a challenging problem despite significant progress. METHODS:A literature search was undertaken using PubMed and the Cochrane Library regarding the options in emergency management of left-sided colonic obstruction focusing on outcomes suc...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,评审

    doi:10.1308/003588408X285757

    authors: Trompetas V

    更新日期:2008-04-01 00:00:00

  • Germ cell tumour: late recurrence after 43 years.

    abstract::We report the late relapse of a patient following 43 years of surveillance of a germ cell tumour, thought to be a pure seminoma, having undergone yolk sac differentiation. The longest previous recorded time to relapse was 32 years (malignant teratoma with adenocarcinoma de-differentiation).(1) This case report demonst...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870811X580442

    authors: Mukhtar S,Beatty J,Agrawal S,Christmas TJ,Jameson C,Huddart RA

    更新日期:2011-07-01 00:00:00

  • A rare differential for sinusitis and visual loss.

    abstract::Erdheim-Chester disease is a rare infiltrative histiocytic disorder with around 800 cases being reported worldwide. Patients most commonly present with skeletal pain, but the condition has been shown to affect multiple other organs. We describe a rare presentation in which the disease infiltrated the sinuses and affec...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2019.0130

    authors: Lee JDE,Gill C,Muzaffar J,Ahmed S,Amel-Kashipaz R

    更新日期:2020-02-01 00:00:00

  • What is a reasonable orthopaedic surgical workload? An analysis of elective and trauma workloads using two different complexity scoring systems.

    abstract::A 1-year prospective study of all surgical activity was undertaken by the Orthopaedic Unit using two weighting systems for operative complexity: the Intermediate Equivalent (IE) and the Operative Complexity Score (OCS). The objectives were to define the difference between caseload and workload, and to formulate a reas...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Pozo JL,Jones CB

    更新日期:1993-09-01 00:00:00

  • Pedunculated, well differentiated liposarcoma of the oesophagus mimicking giant fibrovascular polyp.

    abstract::We present a rare case of a big oesophageal liposarcoma causing dysphagia and weight loss in a 75-year-old patient. Endoscopically, a pedunculated lesion with subtotal obstruction of the oesophageal lumen had been detected and thoracoabdominal oesophageal resection with gastric sleeve reconstruction was performed. Sur...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2017.0117

    authors: Mehdorn AS,Schmidt F,Steinestel K,Wardelmann E,Greulich B,Palmes D,Senninger N

    更新日期:2017-09-01 00:00:00

  • 'One-stop' rectal bleeding clinics without routine flexible sigmoidoscopy are unsafe.

    abstract::Over 90% of patients referred to surgeons for investigation of rectal bleeding have haemorrhoids, fissure-in-ano or proctitis. Full investigation of these patients to exclude colonic neoplasia or inflammatory bowel disease imposes a considerable load on a hospital's resources as well as exposing the patient to signifi...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Toomey P,Asimakopoulos G,Zbar A,Kmiot W

    更新日期:1998-03-01 00:00:00

  • The supratrochlear lymph nodes: their diagnostic significance in a swollen elbow joint.

    abstract::In the differential diagnosis of a swollen elbow, the palpation of the supratrochlear glands is useful. They are not enlarged in a traumatic elbow joint. They are enlarged, discrete and shotty in rheumatoid arthritis. In tuberculosis, they are enlarged, matted and they may caseate and form a cold abscess on the medial...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,评审

    doi:

    authors: Patel DA

    更新日期:2001-11-01 00:00:00

  • Labial fat pad grafts (modified Martius graft) in complex perianal fistulas.

    abstract::Complex perianal fistulas may at times be very difficult to treat. New vascularised tissue can reach the perineum from leg muscles and the omentum. A less well-known source is the labial fat tissue (modified Martius graft) which has a robust posterolateral pedicle and which can be useful as an adjunctive technique for...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Pinedo G,Phillips R

    更新日期:1998-11-01 00:00:00

  • Gauze packing as damage control for uncontrollable haemorrhage in severe thoracic trauma.

    abstract:INTRODUCTION:The usefulness of thoracic damage control (DC) for trauma requiring a thoracotomy is not established. The aim of this study was to clarify the usefulness of thoracic packing as DC surgery. METHODS:This was a retrospective case series study of 12 patients with thoracic trauma suffering uncontrollable intra...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588413x13511609956057

    authors: Moriwaki Y,Toyoda H,Harunari N,Iwashita M,Kosuge T,Arata S,Suzuki N

    更新日期:2013-01-01 00:00:00

  • A case for the removal of the 'normal' appendix at laparoscopy for suspected acute appendicitis.

    abstract::This study suggests that appendicectomy should be routinely performed at laparoscopy for suspected acute appendicitis and that this can be achieved with minimal morbidity. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Grabham JA,Sutton C,Nicholson ML

    更新日期:1999-07-01 00:00:00

  • Transanal endoscopic microsurgery--impact on the practice of a colorectal surgeon in a district general hospital.

    abstract:INTRODUCTION:The objective was to assess the impact on the management of colorectal patients treated in a district general hospital within the first year after the introduction of transanal endoscopic microsurgery (TEM). PATIENTS AND METHODS:Data were collected for consecutive unselected patients who underwent TEM. Co...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588405X51083

    authors: Mihai R,Borley N

    更新日期:2005-11-01 00:00:00

  • Nicorandil associated anal ulcers: an estimate of incidence.

    abstract:INTRODUCTION:Nicorandil is a commonly prescribed antianginal medication that has been found to be associated with painful anal ulceration. The incidence of this complication is unknown. We have used the best data available to us to make an estimate of this figure in a health district with a remarkably stable populatio...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588412X13171221501573

    authors: Colvin HS,Barakat T,Moussa O,Babu H,Slaughter T,Palmer JG,Hinson FL

    更新日期:2012-04-01 00:00:00

  • A comparison of colonoscopy and selective visceral angiography in the diagnosis of colonic angiodysplasia.

    abstract::The results of selective visceral angiography and colonoscopy were compared in the diagnosis of angiodysplasia of the large bowel. Fifty six patients were diagnosed as having angiodysplasia on angiography and 34 of these patients also underwent colonoscopy. Twenty three of the colonoscopies were positive giving a diag...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Salem RR,Wood CB,Rees HC,Kheshavarzian A,Hemingway AP,Allison DJ

    更新日期:1985-07-01 00:00:00

  • Self-assessment of technical skill in surgery: the need for expert feedback.

    abstract:INTRODUCTION:Technical skill has been formally assessed in the Fellow of the European Board of Vascular Surgery Examinations (FEBVS) since 2002. The aim of this study was to examine the relationship between expert assessment and trainee self-assessment. MATERIALS AND METHODS:Forty-two examination candidates performed ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588408X286008

    authors: Pandey VA,Wolfe JH,Black SA,Cairols M,Liapis CD,Bergqvist D,European Board of Vascular Surgery.

    更新日期:2008-05-01 00:00:00

  • Parathyroid hormone-related protein, bone metastases and hypercalcaemia of malignancy.

    abstract::Breast cancer patients frequently develop bone metastases. A newly discovered peptide, Parathyroid Hormone Related Protein (PTHrP), causes humoral hypercalcaemia of malignancy. We have studied whether production of this protein by breast cancers leads to the development of bone metastases or hypercalcaemia. PTHrP was ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Bundred NJ,Walls J,Ratcliffe WA

    更新日期:1996-07-01 00:00:00

  • The incidence of epidural abscess following epidural analgesia in open abdominal aortic aneurysm repair.

    abstract:INTRODUCTION:Complications of epidural catheterisation can cause significant morbidity. Epidural abscess following epidural catheterisation is rare and the reported incidence is variable. The purpose of this study was to review the incidence of epidural abscess in patients undergoing open abdominal aortic aneurysm (AAA...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588410X12518836438886

    authors: Wallace D,Bright E,London NJ

    更新日期:2010-01-01 00:00:00

  • Should business management training be part of medical education?

    abstract::The introduction of modern business management practices in the National Health Service has exposed different levels of management training and expertise between clinicians and hospital managers. This is undesirable and frequently unproductive. This article puts the case for the inclusion of business management traini...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Hornick P,Hornick C,Taylor K,Ratnatunga C

    更新日期:1997-09-01 00:00:00

  • Small bowel knots.

    abstract:INTRODUCTION:Intertwining of bowel loops to form a knot is very rare cause of intestinal obstruction. Among intestinal knots, ileoileal knotting is the most rare, with only a handful of cases reported in literature. We present a rare case of ileoileal knotting and review of small bowel knots. The aim of this review was...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,评审

    doi:10.1308/rcsann.2020.0122

    authors: Beg MY,Bains L,Lal P,Maranna H,Kumar N P

    更新日期:2020-10-01 00:00:00

  • The groin hernia - an ultrasound diagnosis?

    abstract:AIMS:Ultrasound is a non-invasive, non-ionising radiation modality which is highly successful at soft tissue imaging. Groin pain from an occult hernia can be a difficult clinical diagnosis made easier by good imaging. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing and typing the groin...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588403321661334

    authors: Bradley M,Morgan D,Pentlow B,Roe A

    更新日期:2003-05-01 00:00:00

  • Physical status is the principal determinant of outcome after emergency admission of patients with colorectal cancer.

    abstract::A prospective study of 825 consecutive patients with colorectal cancer presenting to three general surgeons in a district general hospital over a 10-year period are reported. In all, 735 patients had an operation and are grouped according to whether their operation was within 24 h of admission (n = 63), more than 24 h...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Kingston RD,Walsh SH,Jeacock J

    更新日期:1993-09-01 00:00:00

  • An inquiry into the decay of teeth.

    abstract::John Hunter's observations on dental caries are described and various early speculative theories of its nature and causation are mentioned. With the demonstration in the late 19th century of the chemicoparasitic nature of the late 19th century of the chemicoparasitic nature of the disease attention focused on dietary ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 历史文章,杂志文章

    doi:

    authors: Cohen B

    更新日期:1982-11-01 00:00:00

  • Partial salvage of avulsed tissue after dog bite.

    abstract::Injuries to the nose can be severe from both a functional and cosmetic perspective. After suffering a dog bite to the central part of the face, an 18-year old woman underwent replantation of the avulsed tissue with the help of microsurgical arterial anastomosis. A venous anastomosis was impossible and venous congestio...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2016.0026

    authors: Øregaard JS,Lang CL,Venzo A

    更新日期:2016-02-01 00:00:00

  • Local anaesthesia and inguinal hernia repair: a cautionary tale.

    abstract::Two patients undergoing inguinal herniorrhaphy developed transient quadriceps paresis after local inguinal nerve block. One sustained a compound fracture of the distal tibia and fibula. The importance of warning the patient and of increasing the awareness of nursing staff to the possibility of quadriceps weakness afte...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Széll K

    更新日期:1994-03-01 00:00:00

  • Paediatric day care surgery: a hidden burden for primary care?

    abstract::The aims of this study were to identify prospectively 'concealed' postoperative problems, to assess the burden of paediatric day care surgery on primary care services and to define a normal recovery period for common children's procedures. At their first postoperative clinic visit, patients and parents were asked dire...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: de la Hunt MN

    更新日期:1999-05-01 00:00:00

  • Pyomyositis of the piriformis muscle in a juvenile.

    abstract::The authors present a case of pyomyositis of the piriformis muscle. This case, the first in the English speaking literature of piriformis involvement in a juvenile, serves to illustrate the need for a high index of suspicion when treating children with symptoms related to impalpable pathology deep in the pelvis and th...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,评审

    doi:10.1308/147870804894

    authors: Burton DJ,Enion D,Shaw DL

    更新日期:2005-01-01 00:00:00

  • 'Beehive on the bladder': a sign of colovesical fistula.

    abstract::The 'beehive' sign on the bladder as seen in cystograms is valuable in diagnosing the presence of colovesical fistula and is invariably associated with the vesical end of the fistulous tract. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Kaisary AV,Grant RW

    更新日期:1981-05-01 00:00:00

  • Spleen preserving management of a non-parasitic splenic cyst in pregnancy.

    abstract::Non-parasitic splenic cysts are rare entities. In pregnancy, they are rarer still, with as few as seven cases reported in the literature. There is little consensus regarding the optimal management of this condition in pregnancy. Although small, the theoretical risk of intrapartum splenic rupture is associated with a f...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2016.0165

    authors: Kapp J,Lewis T,Glasgow S,Khalil A,Anjum A

    更新日期:2016-09-01 00:00:00

  • Management of boys with abnormal appearance of meatus at circumcision for balanitis xerotica obliterans.

    abstract:INTRODUCTION:The aim of this study was to develop a standardised management plan for boys with abnormal appearance of meatus at circumcision for balanitis xerotica obliterans (BXO). METHODS:Between 1995 and 2008, 107 boys underwent circumcision for BXO (confirmed on histology). Of these, 23 had abnormal appearance of ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588411X587145

    authors: Holbrook C,Tsang T

    更新日期:2011-09-01 00:00:00

  • Functional outcome in patients after excision of extracanalicular acoustic neuromas using the suboccipital approach.

    abstract::An audit of surgery for acoustic neuroma was carried out to determine the frequency and nature of postoperative symptoms and their impact upon the patient's quality of life and vocation. Fifty-six patients were interviewed between 6 months and 5 years (mean 26 months) after surgical excision of an acoustic neuroma. Th...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Kane NM,Kazanas S,Maw AR,Coakham HB,Torrens MJ,Morgan MH,Stranjalis G,Butler SR

    更新日期:1995-05-01 00:00:00

  • Inflammatory myofibroblastic tumours of the respiratory system and the impact of the varying patterns.

    abstract::Inflammatory fibroblastic tumours are very rare. They are mostly located in the respiratory system. We present three cases of patients with fibroblastic tumours. The diversity of inflammatory fibroblastic tumours in the respiratory system and the surgical considerations are discussed. Our recommendation is that treatm...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2016.0033

    authors: Lodhia JV,Christensen TD,Trotter SE,Bishay ES

    更新日期:2016-01-01 00:00:00