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Journal of the Royal College of Surgeons of Edinburgh最新文献

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From Hippocrates to the Eskimo--a history of techniques used to reduce anterior dislocation of the shoulder. 从希波克拉底到爱斯基摩人——用于减轻肩部前脱位的技术历史。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
A Mattick, J P Wyatt
{"title":"From Hippocrates to the Eskimo--a history of techniques used to reduce anterior dislocation of the shoulder.","authors":"A Mattick,&nbsp;J P Wyatt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>It has been recognised for thousands of years that the shoulder joint is particularly prone to dislocation following trauma. From the time of Hippocrates, physicians have described a variety of different techniques aimed at reducing shoulder dislocations. In this article we review the historical development of these techniques and suggest that, despite being described as new, many of these are simply variations on an already established method.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"312-6"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21903439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Management of childhood otitis media with effusion by Scottish otolaryngologists. 苏格兰耳鼻喉科医生对儿童中耳炎积液的处理。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
R P Mills, W S McKerrow
{"title":"Management of childhood otitis media with effusion by Scottish otolaryngologists.","authors":"R P Mills,&nbsp;W S McKerrow","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A prospective audit of 5430 initial consultations and 1602 admissions to Scottish hospitals for surgical treatment of otitis media with effusion in childhood in ear, nose and throat departments throughout Scotland has been carried out. The results suggest that Scottish children are assessed by clinicians of appropriate experience when initially seen in outpatients and only a minority (30%) are listed for surgery following their first visit. Not all children have a hearing test at their initial clinic visit. In those cases where surgical treatment is not advised at the first visit, a policy of \"watchful waiting\" is preferred to medical treatment by most clinicians. Bilateral dry tap rates varied between zero in Forth Valley and 19% in Lanarkshire. Fifty one per cent of operations were carried out by consultants and only 3% by SHOs. \"Best practice\" for the initial management of childhood ear problems is widespread in Scotland but there is room for improvement. There is a need for review of the availability of paediatric audiology services.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"321-5"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21903441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Primary locally infiltrative gastrointestinal aspergilloma in a non-neutropaenic child. 非中性粒细胞减少儿童原发性局部浸润性胃肠道曲菌瘤。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
A H Ibrahim, T A al Malki, N Morad
{"title":"Primary locally infiltrative gastrointestinal aspergilloma in a non-neutropaenic child.","authors":"A H Ibrahim,&nbsp;T A al Malki,&nbsp;N Morad","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 21-month-old male child presented with malnutrition and painless abdominal masses. The masses were provisionally diagnosed as being abdominal lymphoma. Pre-operative investigations did not establish any other cause. The diagnosis of primary gastrointestinal aspergilloma was obtained only post-operatively by histopathology and tissue culture. Following surgery, the tumour grew rapidly and massively despite intravenous amphotericin-B, in the recommended doses. The tumour caused recurrent intestinal obstruction which necessitated multiple extensive surgical excisions. The patient finally died due to sepsis and gastrointestinal bleeding. We believe this to be the first description of a primary gastrointestinal aspergilloma with aggressive local infiltration in a non-neutropenic child.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"335-8"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21903444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A case of spigelian hernia at an unusually high anatomical location. 螺旋疝异常高解剖位置1例。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
P J O'Dwyer
{"title":"A case of spigelian hernia at an unusually high anatomical location.","authors":"P J O'Dwyer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"345-6"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21902641","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bollen's jig and anterior cruciate ligament reconstruction. Bollen氏关节和前交叉韧带重建。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
A B Ng, S R Bollen
{"title":"Bollen's jig and anterior cruciate ligament reconstruction.","authors":"A B Ng,&nbsp;S R Bollen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We report the design of a surgical instrument that facilitates the harvest of the autologous patellar tendon in anterior cruciate ligament (ACL) reconstruction. The advantage of this jig is that it is a simple, self-centring device resulting in a reproducible and consistent autograft. Its use also minimises the potential risks of donor site morbidity such as patellar fracture and tendon rupture. We briefly describe our technique and discuss its advantages.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"318-20"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21903440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Facial nerve palsy following intra-oral surgery performed with local anaesthesia. 局部麻醉下口内手术后面神经麻痹。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
G C Cousin
{"title":"Facial nerve palsy following intra-oral surgery performed with local anaesthesia.","authors":"G C Cousin","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The precise cause of Bell's palsy remains unclear. A variety of mechanisms have been linked to this palsy, including viral re-activation, demyelination, oedema, vasopasm and trauma. A link with dental treatment has been suggested previously, and a series of seven cases of facial nerve palsy following intra-oral surgery are reported. All of the patients had local anaesthetic solution containing adrenaline as the vasoconstrictor administered. There may be under-reporting of this association, as patients with facial nerve palsy are treated by specialists from several disciplines, not only maxillofacial surgeons. An association with local anaesthesia administered to permit dental treatment would have important medicolegal consequences, and perhaps go some way to explaining the pathophysiology of Bell's palsy.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"330-3"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21903443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Necrotising perineal infection: a fatal outcome of ischiorectal fossa abscesses. 坏死性会阴感染:坐骨直肠窝脓肿的致命结果。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
K Moorthy, P P Rao, A N Supe
{"title":"Necrotising perineal infection: a fatal outcome of ischiorectal fossa abscesses.","authors":"K Moorthy,&nbsp;P P Rao,&nbsp;A N Supe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Introduction: </strong>Necrotizing perineal infection or Fournier's gangrene is an uncommon but lethal complication of ischiorectal fossa abscesses. It is associated with a high mortality, especially in diabetics and immunocompromised individuals. Attempts have been made to study factors which could serve as prognostic indicators. The role of faecal diversion has not been clearly determined.</p><p><strong>Materials and methods: </strong>The medical records of 8 patients who presented with necrotizing perineal infection as a complication of ischiorectal fossa abscesses were reviewed. Various parameters were studied to see if any of them could serve as predictors of outcome. Mean surface area of involvement was calculated using modified burns assessment criteria. To study the effect of colostomy on the general condition of the patient the physiological and biochemical parameters before and after the procedure were compared. Statistical analysis was done using the unpaired and paired 't' tests.</p><p><strong>Results: </strong>The mean age of the patients was 50.6 +/- 10.3 years. Five patients were diabetic, of whom four died; all the non-diabetics survived. The mean surface area of involvement was 5.1 +/- 0.75%, among the survivors, and 9.6 +/- 3.4% among the non-survivors. Colostomy was performed in four patients one of whom died. While in one patient the colostomy was created along with the initial radical debridement, in three other patients it was formed on days three, five and five, respectively. There was a significant improvement in their general status and biological parameters. All patients with testicular involvement died.</p><p><strong>Conclusion: </strong>Evidence of systemic sepsis at presentation, extent of tissue and testicular involvement, a low haematocrit, a high blood urea and creatinine and a low serum albumin, were associated with a higher mortality. Prompt recognition of the condition, urgent radical surgical debridement and the use of appropriate antibiotics are the mainstays of management. Formation of a diverting colostomy appears to favour survival.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"281-4"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21904710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The incidence of potential conjunctival contamination in tonsillectomy. 扁桃体切除术中潜在结膜污染的发生率。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
G Kelly, P Gana, T Nielsen, F MacGregor
{"title":"The incidence of potential conjunctival contamination in tonsillectomy.","authors":"G Kelly,&nbsp;P Gana,&nbsp;T Nielsen,&nbsp;F MacGregor","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A prospective study of 100 consecutive tonsillectomies was performed to assess the incidence of potential blood contamination of the surgeons' conjunctivae. Operating masks with plastic visors were used during these operations and examined by microscopy to detect blood contamination. 46% of visors were contaminated by blood. There was no significant difference with respect to how the operation was performed, or with the addition of adenoidectomy, but there was a significant difference between the rate of contamination between some surgeons. No surgeon performing more than three operations, however, escaped contamination. We recommend that eye protection be worn routinely in tonsillectomy.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"288-90"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21904712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Training specialist registrars in general surgery: a qualitative study in Tayside. 培训普通外科专科登记员:泰赛德的一项定性研究。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
M Reid, J S Ker, M P Dunkley, B Williams, R J Steele
{"title":"Training specialist registrars in general surgery: a qualitative study in Tayside.","authors":"M Reid,&nbsp;J S Ker,&nbsp;M P Dunkley,&nbsp;B Williams,&nbsp;R J Steele","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>Owing to decreased hours of work and duration of training, there is a need to refashion the training of surgical specialist registrars (SpRs) in the United Kingdom. This requires more guidance for trainers, but consensus regarding good trainer attributes does not exist. This study describes the training practices of Tayside general surgical trainers working with SpRs and highlights good training practice involving technical and patient management skills.</p><p><strong>Methods: </strong>1) Semi-structured interviews carried out with eighteen consultant trainers and twelve SpRs, 2) Action inquiry (i.e. observations and dialogue with participants) during ward, theatre, outpatient clinic and other hospital-based settings with eleven consultant and SpRs pairs.</p><p><strong>Results and conclusion: </strong>Participants reflected on multiple training episodes and evaluated their impact. Relatively positive or negative impacts on their skill learning, self-esteem and relationship with the trainee or trainer were described. These are presented and discussed in terms of their implications for equipping trainers with techniques for training registrars and those factors which have hindered the adoption of successful strategies.</p>","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"304-10"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21903438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Mycobacterium tuberculosis presenting as sternal osteomyelitis. 结核分枝杆菌表现为胸骨骨髓炎。
Journal of the Royal College of Surgeons of Edinburgh Pub Date : 2000-10-01
K Somasekar, A Somasekar
{"title":"Mycobacterium tuberculosis presenting as sternal osteomyelitis.","authors":"K Somasekar,&nbsp;A Somasekar","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76058,"journal":{"name":"Journal of the Royal College of Surgeons of Edinburgh","volume":"45 5","pages":"345"},"PeriodicalIF":0.0,"publicationDate":"2000-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21903447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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