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Showing papers by "Leicester Royal Infirmary published in 1978"


Journal ArticleDOI
TL;DR: In a randomized, prospective study of patients undergoing large bowel anastomosis, 47 patients received subarachnoid block and light general anaesthetic, and 51 received conventional general anaesthesia with intermittent positive pressure ventilation.
Abstract: In a retrospective study, 68 large bowel anastomoses carried out on patients under subarachnoid or extradural spinal nerve block with light general anaesthesia were compared with 26 anastomoses on patients receiving general anaesthesia alone. Dehiscence occurred in 7.4% of anastomoses performed under spinal nerve block compared with 23.1 % in the control group. In patients receiving morphine, anastomotic dehiscence occurred after 15.2% of operations, compared with 5.9% in patients receiving pethidine. These differences are not statistically significant. However, the findings indicate the need for larger prospective studies.

48 citations


Journal ArticleDOI
TL;DR: During the course of a 30 month study period, 26 patients with typical chronic granulocytic leukaemia (CGL) developed karyotype abnormalities in addition to the Philadelphia (Ph1) chromosome.
Abstract: During the course of a 30 month study period, 26 patients with typical chronic granulocytic leukaemia (CGL) developed karyotype abnormalities in addition to the Philadelphia (Ph1) chromosome. All cases had received at least 14 months continuous low dose busulphan, and the chromosome changes were found before clinical transformation in six patients and at the time this occurred in 20. Survival following the discovery of these additional abnormalities was short, with a median of 11 weeks for the whole group. Trisomy 8 was the commonest additional chromosome abnormality, but no one karyotype change was clearly associated with shorter survival than another. 23 of the 26 have died as a direct result of their disease, forming part of a total of 40 deaths from typical CGL encountered during the study period where karyotype analyses were performed during the terminal stages of the disease. Of these 40, only two (5%) patients showed no chromosome abnormalities extra to the Ph1 prior to death. (The 17 non-study patients who died were similar in all respects to the 23 from the study group, but had no prior chromosome studies performed during the chronic phase of the disease.) It is suggested that an expanding aneuploid or pseudodiploid clone arising from the leukaemic cells during the benign phase of CGL can be used to mark the sometimes ill-defined onset of the malignant phase in all but a small proportion of cases.

28 citations