A double-blind, controlled, clinical trial of spironolactone for benign prostatic hypertrophy*Castro, J E; Griffiths, H J L; Edwards, D E
doi: 10.1002/bjs.1800580703pmid: 4104441
A double-blind, controlled, clinical trial of spironolactone (Aldactone-A), 50 mg. b. d., showed this to be better than a placebo for the short-term treatment of benign prostatic hypertrophy, although the advantage was not maintained over a longer period of time. There was considerable response to the placebo and the importance of comparative trials with objective measurements is discussed.
The effect of selective gastric or extragastric vagotomy on gastric secretion in conscious catsSpencer, John; Grossman, Morton I
doi: 10.1002/bjs.1800580704pmid: 5089957
Earlier studies in dogs showed that in animals with gastric fistulas, selective gastric vagotomy decreased maximal acid secretion in response to gastrin but not to histamine, and that in animals with Heidenhain pouches, selective extragastric vagotomy increased maximal response to gastrin but not to histamine. The present study sought to determine whether similar changes occurred in cats. In cats with gastric fistulas, selective gastric vagotomy reduced maximal response to pentagastrin and to histamine by about the same extent. In cats with Heidenhain pouches, selective extragastric vagotomy had no effect on the response to pentagastrin. It is concluded that there is a species difference between the dog and the cat regarding the effects of selective gastric and selective extragastric vagotomy on gastric acid secretion in response to gastrin. It is not yet known whether man fits the pattern of the dog or the cat.
Lactose intolerance following extensive small intestinal resectionRichards, Anthony J; Condon, John R; Mallinson, C N
doi: 10.1002/bjs.1800580705pmid: 5089958
Lactose tolerance following extensive small intestinal resection was studied in 4 adult patients, using the ooral lactose-tolerance test. Three of the 4 patients had flat lactose-tolerance curves with normal glucosegalactose tolerance. The fourth case had a border-line normal lactose-tolerance curve. One of the patients with a flat lactose curve was treated with a lactose-free diet which resulted in a reduction in faecal fat and number of bowel actions per day.It is concluded that some patients who have undergone massive small-bowel resection are unable to absorb lactose and possibly other disaccharides, and this group of patients may be helped by disaccharidefree diets.
Pancreatic cysts: A report of 10 casesOlurin, E O
doi: 10.1002/bjs.1800580708pmid: 5089960
Ten cases of pancreatic cysts seen in 12 years in the University College Hospital, Ibadan, are reported. The clinical features and diagnoses are reviewed and found to be similar to those reported elsewhere. Pancreatic cysts occur in a younger age-group in this series than in other reports and this is related to malnutritional fibrocalcific pancreatic disease. The classification of pancreatic cysts is discussed and modified according to the experience of this series. The operative management of pancreatic cysts is briefly discussed.
The long-term stability of the insulin test after partial vagotomy in the dogSpencer, John; Stening, G Frank
doi: 10.1002/bjs.1800580710pmid: 5089962
Five dogs were prepared with gastric fistulae, and partial vagotomy was performed by division of one vagus in the neck and a main vagal trunk in the lower thorax.The acid secretory responses to histamine dihydrochloride (o.16 mg. per kg.-hr.), and to graded intravenous doses of insulin (0.03, 0.06, 0.12, 0.5, and 1 U. per kg.) were measured soon after vagotomy and again 6 months later.There was no significant change in the acid response to either histamine or insulin during the 6 months after vagotomy either in timing of the peak output or in the dose of insulin required for highest peak acid output. It is concluded that no detectable reinnervation occurs in the dog in this period following gastric vagotomy.
Vascular injuries resulting from arterial puncture or catheterizationHall, Robert
doi: 10.1002/bjs.1800580711pmid: 5089963
Diagnostic puncture or catheterization is probably the commonest cause of serious arterial injury in current civilian surgical practice. The most frequent complications are arterial thrombosis, bleeding from the puncture site, false and arteriovenous aneurysm formation, and cerebral embolism. Eight instances of arterial occlusion have been treated in one hospital in less than 18 months–1 followed arterial puncture, 3 followed operative insertion of catheters maintained for repeated blood-sampling, I followed Seldinger catheterization for arteriography, and 3 followed cardiac catheter studies–during which time 1400 such procedures were carried out.Arterial spasm and trauma, large catheter size, protracted catheter maintenance, and low cardiac output seem to be factors particularly liable to produce sufficient damage to precipitate complications, together with thrombosis consequent to sustained heavy local pressure to arrest haemorrhage from the site of arterial puncture.Early surgical correction was successful on each of 6 occasions, but in the 2 cases in which procrastination had occurred major arm amputations became necessary.