Factors affecting revision rate after continent ileostomy

Our aim was to determine factors that may predispose to malfunction of a continent ileostomy. Among 299 patients who underwent continent ileostomy and were followed up for at least one year, the need for revision of the ileostomy was compared by sex, age, type of initial operation, and type of revision. Revision was required less often in females, younger patients, and patients undergoing proctocolectomy and continent ileostomy. However, the rate of subsequent revision was similar after the two types of repair (repair of old valve vs construction of new valve). Constructing a continent ileostomy in stages is not necessary; patients undergoing proctocolectomy and continent ileostomy required fewer revisions than did those who had a Brooke ileostomy prior to their continent ileostomy. Moreover, a malfunctioning valve should be revised rather than a new one created; revision was technically simpler and gave comparable results.     

Compensatory thyroid hypertrophy after hemithyroidectomy in rats

Thyroid enlargement occurs in association with a variety of circumstances characterized by an impaired capacity of the gland to secrete adequate amounts of hormone. To elucidate the factors responsible for such compensatory thyroid growth, particularly the role of TSH, we have observed the response of the serum TSH, T3 and T4 concentrations following hemithyroidectomy in the rat, and have attempted to correlate changes in these functions with changes in the weight and histology of the thyroid remnant. Hemithyroidectomy was performed in male Sprague-Dawley rats weighing 150 to 370 g, sham-operated animals serving as controls. As compared to findings in sham-operated animals, serum T4 concentrations declined promptly after hemithyroidectomy. In Experiment I serum T4 concentrations remained low for about 10 days and then returned to initial values. In Experiment II serum T4 concentrations remained lower than initial T4 values or values found in sham-operated animals until 34 days after hemithyroidectomy. Serum T3 concentrations were not significantly altered after hemithyroidectomy in either group but tended to be lower in the hemithyroidectomized animals. Serum TSH concentrations increased within 3 days after hemithyroidectomy and, for as long as 21 weeks, remained at values higher than those present preoperatively or those seen in sham-operated animals. Thyroid lobe weight increased following removal of the contralateral lobe and this increase was also sustained throughout the duration of the experiments. Biochemical and histological observations indicated that enlargement of the residual lobe was due to hypertrophy rather than hyperplasia.     

The effect of a benzalkonium chloride-containing nasal spray on human respiratory mucosa in vitro as a function of concentration and time of action

Human respiratory mucosa was exposed to oxymetazoline nasal spray in varying concentrations and for varying periods of time in vitro. The drug destroyed the tissue in a concentration- and time-dependent manner. In the experiments with various concentrations of the spray, some tissue fragments retained their viability throughout the experiment. This number increased parallel to a decrease in concentrations of the test substance. All the tissue fragments exposed to undiluted nose spray underwent severe destructive alterations during the exposure period. These alterations appeared first and were most extensive in those exposed for the longest periods of time. It has previously been demonstrated that the toxic effect of oxymetazoline nasal spray in vitro is probably due to the preservative benzalkonium chloride. The apparent lack of consistency between the toxic effects of benzalkonium chloride in vitro and in vivo is discussed, with special reference to protective systems absent in vitro but present in vivo.     

A compact high vacuum heating chamber for in-situ x-ray scattering studies

A very compact multi purpose high vacuum heating chamber for x-ray scattering techniques was developed. The compact design allows the chamber to be installed on high precision diffractometers which usually cannot support heavy and/or large equipment. The chamber is covered by a Be dome allowing full access to the hemisphere above the sample which is required for in-plane grazing incident x-ray diffraction and out-off plane wide angle x-ray diffraction.     

MR imaging of impingement and rotator cuff disorders. A surgical perspective

The role of MR imaging in the diagnosis of impingement and rotator cuff disorders is expanding greatly. This article discusses the clinically pertinent history, physical examination, and surgical treatment of rotator cuff problems. A rationale for consideration of open, "mini-open," and arthroscopic surgical intervention is proposed. The utilization of MR imaging by the orthopedic surgeon for nonoperative, preoperative, and postoperative decision-making are presented. A close working relationship between the radiologist and the orthopedist is emphasized.