Reversed ileal segment for treatment of ileostomy dysfunction. Clinical application

Persistent, profuse ileostomy diarrhea developed gradually in a patient over a 12-hour period after proctocolectomy for ulcerative colitis. There was no evidence of ileostomy stenosis or dilation of the ileum proximal to the stoma. He was successfully treated with a reverse ileal segment of 10 cm, and gained 14 to 18 kg. ileostomy output became semisolid and decreased from 1,000 to 2,000 ml/day to 600 ml/day. The transit time changed from 12 minutes to 2 1/2 hours. Antiperistaltic segments of intestine prolong transit time and allow for greater absorption. While most patients with ileostomies are not troubled by severe diarrhea, the small proportion who are may be candidates for a reversed ileal segment.     

Localization of nonpalpable breast lesions detected by xeromammography

A technique for localizing nonpalpable lesions of the breast using methylene blue dye is described. This technique is recommended for its accuracy, patient acceptance, and reduction in size of the biopsy specimen.     

Detection and management of hypercoagulability

Patients at high risk of having thromboses can be identified not only on the basis of clinical criteria but also on the basis of laboratory studies. With use of a condensed coagulation profile consisting of six laboratory tests, the clinical impression of hypercoagulability can be confirmed in approximately 90 per cent of cases. Therapy directed to correct specific laboratory abnormalities may be more efficacious than nonspecific therapy.     

Recurrent nocturnal asthma after exposure to grain dust

It has been shown that serotonin influences self-stimulation and avoidance conditioned reactions in rats in a different way. Serotonin administration caused a reorganization of self-stimulation process and enhanced its frequency; the avoidance reaction grew weaker and was achieved with a longer latency. Alternation of stages of activation and inhibition was observed in the EEG of the neocortex, hypothalamus and hippocampus as well as shifts in the heart rate. These changes did not always correlate with the animals' behaviour. Unidirectional, yet different serotonin effects on various behavioral reactions, brain electrical activity and vegetative processes testify to a relative independence of their mechanisms.     

Clinical evaluation of 99mTc-pyridoxylideneglutamate for hepatobiliary scanning

Clinical evaluation of hepatobiliary scanning using 99mTc-PG was done in twenty normal volunteers and eighty-three patients with liver and biliary tract disease. Satisfactory images of the biliary tract were obtained using small dosages of this agent. In normal humans, the agent reached the liver in 5 minutes, and the common bile duct, gallbladder, and duodenum in 10 to 20 minutes. The gallbladder was not visualized when the cystic duct was obstructed in patients with acute and chronic cholecystitis. In patients with partial common bile duct obstruction, a distended duct was visualized and there was delay in transit of radioactivity into the duodenum. With complete common bile duct obstruction, no radioactivity was seen in the biliary or gastrointestinal tracts up to 24 hours after injection. Hepatocellular disease was characterized by delayed liver clearance and delayed visualization of the biliary and gastrointestinal tracts. There were no toxic or other untoward effects in any patients.     

Ribosomal apparatus of liver cells in the process of carinogenesis induced by 4-dimethylaminoazobenzene

The antigen of hepatitis B was repeatedly examined in 1356 adults patients with acute viral hepatitis. In 701 patients the HBAg was positive at the beginning of illness and in 657 was negative. The maximum of the negative HBAg results could be found in the lower age groups, whereas the maximum of the positive HBAg results was shifted to the 5th and 6th decade. In HBAg positive cases of hepatitis more numerous anicteric and asymptomatic forms could be observed on the other hand, however, at the same time also o more cholestatic forms and subacute necrotizing and malignant forms appeared. The HBAg positive hepatitis had on average also a more serious form and course. From the epidemiological point of view the admission to the hospital, which preceded in 51% of patients appeared as the most important factor. In 16.3% of patients the HBAg postivity persisted still 6 months after the discharge from the hospital.