Laparoscopic port site recurrences in oncologic surgery--a review

The aim of this paper was to review the world's literature regarding port site recurrences. A Medline search was performed for all port site recurrences published in the literature. These reports were analysed and port site recurrences studied to determine initial stage of cancers, time to recurrence and whether the port site was an isolated site of recurrence or part of widespread intra-abdominal disease. The possible aetiologies were similarly reviewed and several recent basic science reports assessed. To date, 93 port site recurrences have been published. These have occurred with colorectal cancers as well as ovarian, gastric, pancreatic and other malignancies. Often, these recurrences are isolated and most standard means of prevention of cell dissemination may not prevent their occurrence. Possible mechanisms include aerosolisation of tumour cells, exfoliation, and changes in immune function. Port site recurrences continue to be reported. Their aetiology is unclear but the occurrence is of concern and requires continued scrutiny for laparoscopic oncologic surgery.     

The effect of trauma on the ocular penetration of intravenous ciprofloxacin

PURPOSE: To study the intraocular pharmacokinetics of intravenously administered ciprofloxacin following eye trauma. METHODS: Twenty-three New Zealand albino rabbits and 12 Yorkshire pigs each received a surgically induced scleral injury to the right eye. Following repair, each rabbit received a single 30-mg intravenous infusion of ciprofloxacin. Each pig received either two 200-mg doses or two 400-mg doses of intravenous ciprofloxacin given 12 hours apart. Vitreous and serum samples were harvested at 0.5, 1, 4, 6, and 12 hours after antibiotic administration in rabbits and 1 hour after the second dose in pigs. Bioassays for ciprofloxacin were performed on each sample, and results were statistically compared by t test. The untraumatized left eye in each animal served as a control. RESULTS: The mean vitreous concentration of ciprofloxacin in traumatized rabbit eyes was 0.37 microgram/ml. This level was sustained above levels in control eyes (0.18 microgram/ml) for at least 4 hours following antibiotic administration. In control eyes, intravitreal levels peaked at 1 hour. Mean vitreous concentrations +/- SD in traumatized pig eyes were 0.091 +/- 0.017 microgram/ml in swine that had received 200-mg doses of ciprofloxacin vs 0.312 +/- 0.153 microgram/ml in swine that had received 400-mg doses (P = .02). Mean vitreous concentrations of ciprofloxacin in control eyes were not affected by increasing dosage. CONCLUSION: In both animal models, experimental surgical trauma increased intravitreal ciprofloxacin delivery. In addition, systemically administered ciprofloxacin achieved intravitreous levels exceeding minimum inhibitory concentrations for common ocular pathogens, suggesting a role for ciprofloxacin in the prophylaxis of posttraumatic endophthalmitis.     

Relationship of posture and age to urinary protein excretion

The influence of posture and age on urinary protein excretion was studied in 120 normal men volunteers. The supine excretion rate was less than 140 mug/min in all but two people (median value 38 mug/min) and tended to increase with age. The excretion rate decreased on quiet standing in 80% of people, which corresponded to a fall in creatinine-clearance. In the remaining 20% protein excretion increased on standing but generally remained within normal limits and was dissociated from changes in creatinine clearances. This increase was more prevalent in younger people and may represent a phenomenon analogous to orthostatic proteinuria, differing only quantitatively.     

Subjective and electrophysiologic tests in brain-stem lesions

A battery of subjective and electrophysiologic auditory and vestibular tests were administered to 22 patients with neurologically confirmed brain-stem lesions to investigate the interrelationships between the test results. Acoustic-reflex and simultaneous midplane binaural loudness-balance abnormalities were related to N2 and N3 abnormalities on the brain-stem evoked-response measures. Unilateral abnormalities in low-redundancy speech tests, prolonged auditory reaction times, and reduced loudness growth on the alternate binaural loudness-balance test were related to ipsilateral N4 abnormalities or contralateral N5 abnormalities on the brain-stem evoked-response measures.     

Tail-pinch stimulation: sufficient motivation for learning

A paper clip applied to the tails of rats induced gnawing and eating, which decreased in latency and increased in duration with experience. With sustained pressure to the tail, rats learned a new habit in order to gain access to wood chips on which to gnaw. That these are also properties of behavior elicited by electrical brain stimulation suggests that both manipulations may act through the same mechanism. These results support the hypothesis that a nonspecific arousing stimulus can be a sufficient condition for establishing learned habits.     

Treatment of pseudarthroses and ununited crural bone fractures with transosseous compression-distraction osteosynthesis

The materials of clinical observations of 103 patients with pseudarthrosis and unhealing crural fractures, in whom 104 operations of compression-distraction osteosynthesis were accomplished, are analysed. The results of the treatment in various groups of patients are described.