Laparoscopic versus conventional appendectomy: a prospective randomized study

The discussion about laparoscopic appendectomy has increased since the introduction of this method. Randomized comparisons are still feasible, whereas this cannot be stated for other laparoscopic procedures (e.g., laparoscopic cholecystectomy). This randomized controlled trial included 170 patients. Open appendectomy was employed in 83 patients, and 87 were treated laparoscopically. The treatment groups were comparable regarding age, sex, Broca index, ASA classification, preliminary operations, and preoperative leucocytes. No statistically significant differences could be found with respect to surgical and general complications, operating time, consumption of analgesics and antibiotics, and return to work. The analysis revealed a statistically significant shorter hospital stay, a shorter time until return to normal physical activity, and a shorter duration of complaints for the laparoscopic group. We were unable to demonstrate any statistically significant advantage in using the open procedure.     

Cerebellar arachnoid cyst in a firesetter: the weight of organic lesions in arson

Disruption of synaptic activity of a number of cerebral structures (e.g., neostriatum, amygdala, and thalamus) produces marked deficits in retention of instrumentally conditioned behaviors. When animals are given a relatively high number of training trials or high intensities of footshock during learning, however, such disruption is considerably less effective. Since there is a close anatomical and functional relationship between the neostriatum and the substantia nigra, it was of interest to determine whether enhanced training with a high level of footshock would prevent the reported amnesic state induced by injections of GABA antagonists into the latter structure. Rats were trained in a one-trial inhibitory task, using 0.2 or 0.4 mA, and then injected with microgram quantities of picrotoxin or bicuculline into the substantia nigra and posterior region of the zona incerta; retention was measured 24 h later. Only those groups that had been injected into the nigra and trained with 0.2 mA showed amnesia. These results support the hypotheses that (a) the normal activity of a set of structures is essential for the development of memory consolidation and (b) after an enhanced learning experience these structures may participate in memory consolidation, but are not necessary for the occurrence of this process.     

Optokinetic and pursuit system: a case report

Thinking-aloud protocols provided by Joseph and Patel were reanalyzed to determine the extent to which their conclusions could be replicated by independently developed coding schemes. The data set consisted of protocols from four cardiologists (low domain knowledge = LDK) and four endocrinologists (high domain knowledge = HDK), individually working on a diagnostic problem in endocrinology. The two analyses agree that the HDK physicians related data to potential diagnoses more than did the LDK group and were more focused on the correct diagnostic components. However, the reanalysis found no meaningful difference between the groups in diagnostic accuracy, speed of diagnosis, or the breadth of the search space used to seek a solution. In the reanalysis, the HDK physicians employed more single-cue inference and less multiple-cue inference. The generalizability of results of protocol-analysis studies can be assessed by using several complementary coding schemes.     

Renal cell cancer and concomitant transitional cell cancer of the renal pelvis and ureter in the same kidney--report of 4 cases and review of the literature

Three patients (1 man, 81 years old; 2 women, 56 and 61 years old) had renal cell cancer and transitional cell cancer in the same kidney, and another patient (female, 77 years old) had renal cell cancer and transitional cell cancer in the ipsilateral ureter. Simultaneous occurrence of renal cell cancer and transitional cell cancer is an extremely rare entity with only 15 cases having been reported.     

Adult Fanconi syndrome with proximal muscle weakness and hypophosphatemic osteomalacia: report of a case

A 42-year-old female presented with progressive proximal muscle weakness, generalized hyperreflexia, marked bone pain, severe lumbago and knee arthralgia. Electromyographic study showed short-duration (5-10 msec), variable amplitude (200-2500 microV) polyphasic potentials. A muscle biopsy specimen revealed non-specific type II fiber atrophy. After a comprehensive laboratory work-up, adult Fanconi syndrome was diagnosed. The patient's symptoms, including bone pain and proximal muscle weakness, were relieved after a six-week supplement of tricalcium phosphate, vitamin D3 and sodium bicarbonate. The hyperreflexia also became less brisk.     

High-pressure liquid chromatographic determination of thiothixene in pharmaceutical formulations

A method was developed for the quantitative determination of thiothixene in pharmaceutical formulations by high-pressure liquid chromatography after dissolution of the sample in methanol.