Sciatic-like referred pain after rubberband haemorrhoidal ligation.
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Biomedical subjects
Publications and source records attributed to N Werbin.
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We studied 347 patients with primary colorectal carcinoma treated by surgery during 1973-1983: 64 (18.2%) with right colon carcinoma, 158 (45.7%) with left colon carcinoma, 14 (4.2%) with transverse colon carcinoma, and 110 (31.9%) with rectal carcinoma. We compared the right-sided carcinoma (RSC) and left-sided carcinoma (LSC) groups. Obstruction was found in 17.2% of RSC compared with 20.3% LSC patients (P greater than 0.05). Advanced disease (Dukes stages C and D) was found in 34.4% on the right and 47.8% on the left side (P = 0.01). Crude 5-year survival rate, by life table method, was 71% on the right and 66% on the left side (P greater than 0.05); this difference became significant (P = 0.03) when Dukes stage B patients were compared. We conclude that patients with RSC are not diagnosed, as is commonly believed, at advanced stages of the disease. We found that the 5-year survival rate of RSC patients was the same or, occasionally, better than that of LSC patients.
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A new antiseptic contrast material, composed of sodium diatrizoate-meglumine diatrizoate and PVP-iodine solutions, was prepared and tested for operative cholangiography. It was tested in vitro, and in vivo in dogs and displayed satisfactory contrast radiologic features, and strong and rapid bactericidal action without detectable side effects. It seems to be promising in reducing the risk of bacterial spread during cholangiography.
One hundred patients underwent anal dilatation for acute or chronic anal fissure during the period 1983-1984; white blood count, serum, muscle enzymes, and blood cultures were done. Positive blood cultures were found following the procedure in eight patients. A correlation based on serum enzymes, bacteremia, and trauma can be made. Prophylactic broad-spectrum antibiotics are recommended for patients at risk.
A 58-year-old man with recurrent spontaneous perforations of the colon is reported. The first two events were of the sigmoid colon, and a sigmoidectomy was performed after the second perforation. The third spontaneous perforation had occurred in the transverse colon, however, although a patent sigmoid colostomy was present. Neither primary colonic pathology nor elevated intraluminal pressure were found, which means that the cause and pathogenesis of these perforations are unknown. Six months later, a subtotal colectomy with ileo-sigmoid anastomosis was performed with an apparent satisfactory result.
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A variety of pathological changes with clinical and prognostic significance is described in axillary lymph nodes removed at mastectomy. We studied 572 lymph nodes removed from 43 women and 1 man during a radical or modified radical mastectomy performed for carcinoma of the breast. We found that in about one-third of the specimens some degree of fat infiltration, or changes, was present; metastases were found in either fatty or nonfatty lymph nodes. We conclude that the presence of fat in axillary lymph nodes does not influence implantation of tumor cells from a primary carcinoma of the breast and has to be reported as an anatomic variant.
The effect of splenectomy on wound healing has been studied in standard laparotomy wounds in rats. Significant differences in wound histology, fibroblastic labelling indices, bursting pressure, and IgM levels were found between chronically asplenic rats and controls. Autotransplantation of the spleen conferred some increase to wound strength. Acute asplenic rats have not demonstrated the same changes. It is concluded that the spleen influences wound healing probably through a fibroblastic stimulating mechanism.
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A patient contracted tuberculosis after 2 operations for morbid obesity. The difficulty in diagnosis and treatment is described. Jejuno-ileal bypass is a non-physiological operation, with many reported complications and side effects. Following this short experience the author and his colleagues have now abandoned this operation. Patients suffering from malnutrition as a result of slimming operations should be carefully monitored for tuberculosis.
A new antiseptic contrast material, composed of sodium diatrizoate-meglumine diatrizoate and PVP-iodine solution, was prepared and tested for retrograde cystography. It was tested in vitro and in dogs, showed satisfactory radiological features and rapid wide bactericidal action without detectable side effects. Septic complications following radiological demonstration of the urinary tract may be reduced.
Two cases of patients developing symptoms and signs of zinc deficiency while on total parenteral nutrition are presented. Supporting causes for the appearance of early low serum zinc levels are discussed. These cases serve to further stress the need of adding trace elements to solutions given to patients on long-term total parenteral nutrition.