Reconstruction of the biliary tract using biliary-duodenal interposition of a defunctionalized jejunal limb

Interposition of a defunctionalized limb of jejunum between the confluence of the hepatic ducts and the duodenum seems to have some advantages. Biliary-jejunal anastomosis can be performed in a wider diameter, if necessary; duodenal function is kept almost normal, and the isolated segment of jejunum prevents the duodenojejunal reflux from getting to the biliary tract. The records of 19 patients upon whom hepatico-jejuno-duodenostomy was performed were reviewed. Seventeen patients had iatrogenic lesions and benign strictures of the common bile duct. Two patients had malignant tumors of the common bile duct. The postoperative follow-up period ranged from six months to five years. The average postoperative time was ten days. Two transient bile leaks were observed. Two patients had postoperative episodes of cholangitis. In both, the hepatico-jejunostomy was narrow, and stones were found in the intrahepatic position. A new and wider cholangiojejunostomy was performed. All of the patients were investigated roentgenographically after contrast material was given orally. Only two of the patients were found to have an enteric-biliary reflux which partially filled the intrahepatic biliary branches, but this was only observed at the time the abdomen was compressed.     

Effects of binding policy and other factors on the availability of journal issues

Random samples of journal issues, derived from a test set of 106 biomedical journal titles, were checked against the shelves of the Woodward Biomedical Library under circulating and noncirculating conditions. As well as circulation, binding procedures and duplication of sets were seen to affect availability. Indications are that the practice of binding journals upon completion of the volume may remove them from use at a time of peak demand. The usefulness of second sets of journals appeared to decline rapidly within a few years after publication. A change from circulating to noncirculating conditions may have increased availability certain journals by discouraging use.     

Differential expression of mGluR5 metabotropic glutamate receptor mRNA by rat striatal neurons

The ability to control the degree and spatial distribution of cooling in biological tissues during a thermally mediated therapeutic procedure would be useful for several biomedical applications of lasers. We present a theory based on the solution of the heat conduction equation that demonstrates the feasibility of selectively cooling biological tissues. Model predictions are compared with infrared thermal measurements of in vivo human skin in response to cooling by a cryogen spurt. The presence of a boundary layer, undergoing a liquid-vapour phase transition, is associated with a relatively large thermal convection coefficient (approximately 40 kW m-2 K-1), which gives rise to the observed surface temperature reductions (30-40 degrees C). The degree and the spatial-temporal distribution of cooling are shown to be directly related to the cryogen spurt duration.     

Optical imaging of transient acoustic fields generated bypiezocomposite transducers

Transient surface displacements of 1-3 piezocomposite transducers are measured and their correlative effects on the diffraction of the transmitted pulses are studied. The displacements of the surface of a 210 μm pitch piezocomposite are probed with a heterodyne, optical interferometer. An animate sequence is then built from the stored transient displacements so that each frame shows the instantaneous state of the surface of the piezocomposite. Such an animation proves to be a powerful analysing tool which provides a real insight into the piezocomposite's impulse behavior. Finally, the ultrasonic field transmitted in water and measured by the same optical probe is compared with simulations based on the diffraction impulse theory. The results of that comparison clearly show that, as far as diffraction is concerned, a piezocomposite transducer behaves like a homogeneous material     

Invasive electrophysiologic evaluation in octogenarians: is age a limiting factor?

To assess the indications, diagnostic yield, and incidence of complications of electrophysiologic testing in the elderly we reviewed our experience with 60 procedures in 45 patients aged > or = 80 years (range 80 to 92 years, mean age 83) undergoing full electrophysiologic evaluation in our laboratory over the past 7 years. The yield of inducible ventricular tachycardia (31%), supraventricular tachycardia (4%), and previously unsuspected conduction abnormalities significant enough to warrant permanent pacemaker implantation (9%), together with the low incidence of complications (1 patient had a deep venous thrombosis and femoral artery pseudoaneurysm, representing an incidence of 2.2% of patients undergoing studies or 3.3% incidence of complications per procedure), suggest that invasive electrophysiologic procedures in the elderly can provide useful information at a complication rate comparable with that of younger patients.     

Ménétrier disease associated with a gastric adenocarcinoma. Apropos of 2 cases

PURPOSE: The purpose of this project was to increase use of the Physician Data Query and Patient Information File services of the National Cancer Institute in a clinical setting. OVERVIEW: A patient education demonstration project was conducted at the University of Rochester Cancer Center using a touch-screen computer program called CancerHelp. Two computers were purchased, one stationed in the Patient Library at the University of Rochester Cancer Center and one circulated to three affiliated hospitals. Demographic information was asked at the beginning of the program and an evaluation was elicited at the end of the program. All information was given voluntarily; users of the system could bypass the questions if they wished. The computer program was very well received by patients and their families. The program was used 1758 times over 6 months. CLINICAL IMPLICATIONS: A touch-screen computer program can be an effective method for distributing cancer information.