Inguinal cord lipoma.
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Biomedical subjects
Publications and source records attributed to A N Fawcett.
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Recurrence of an inguinal hernia following routine repair is not influenced by the convalescent time off work. Advice on this interval off work should not be influenced by the type of hernia, or the physical content of the patient's occupation. To determine if this is the case a questionnaire was sent to the 32 consultant surgeons and 487 general practitioners in the Nottingham district. They were asked when they advised males between 18 and 65 years of age to return to work following a routine hernia repair and what factors influenced this time interval. The median advised time off work (4-6 weeks) was longer than that proposed by earlier studies (3-4 weeks). The advice of only 4% of doctors was not influenced by other factors. The physical content of the patient's job and whether he was self-employed had most influence on the advice doctors gave on when to return to work. In conclusion most doctors are wrongly advising patients on when to return to work following an inguinal hernia repair.
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Chronic administration of raw soybean flour containing active trypsin inhibitor to dogs reduced the pancreatic output of trypsin and chymotrypsin in response to cholecystokinin. Dogs stimulated by a meat meal showed no consistent alteration in the output of trypsin and chymotrypsin when given additional duodenal infusions of trypsin and chymotrypsin, or canine pancreatic juice, or ovalbumin trypsin inhibitor. Two dogs, whose pancreas was stimulated by intraduodenal infusion of amino acids, showed no consistent change when trypsin, or trypsin together with trypsin inhibitors, or trypsin together with canine pancreatic juice was infused concurrently into the duodenum. These results indicate that feedback control of pancreatic enzyme secretion, of the type proposed on the basis of studies similar to the present in rats, does not exist in dogs.
Prolonged near maximal pancreatic secretion in conscious dogs has been found to result in a metabolic acidosis. This is mild and is accompanied by respiratory and other forms of compensation. Measurements of blood bicarbonate or base-excess changes cannot be used to estimate pancreatic bicarbonate output. The acidosis caused by pancreatic secretion cannot explain the changes in bicarbonate concentration seen in pancreatic juice during prolonged secretion.
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The response of the pancreatic bicarbonate secretory mechanism to secretin and the relationship between bicarbonate concentration and flow rate in pancreatic juice have been re-examined following reports describing decreasing levels of bicarbonate concentration at high flow rates. Both anaesthetized and chronic fistula dogs were used. The results show that when high doses of secretin elicit high rates of flow of pancreatic juice the bicarbonate concentration rises to a peak which is constant over a wide range of stimulation and flow rates.
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