A study of perineal wound healing after abdominoperineal resection

A comparative study of 53 cases has revealed that a technique of complete primary closure of the perineal wound after abdominoperineal resection of the rectum and anal canal appears to be a superior, more rational approach than other orthodox techniques. (It is unsuitable for any case contaminated with pus or faeces during operation.) Redivac apparatus used through a separate route for continuous drainage from the sacral cavity has made the postoperative care easier for nurses and surgeons and this period more comfortable for the patient. It provides a simple method compared with other suction apparatus used for the same purpose. Of the 53 cases, 12 were operated on using a traditional technique involving the closure of the perineal wound around a tube drain connected to an underwater seal, while in the remaining 41 the approach described here was used. Primary healing of the perineal wound with the later approach was obtained in about 88 per cent. With the other technique the figures were 34 and 66 per cent respectively for early healing within 3 weeks and delayed healing between 3-8 weeks. Primary healing of the perineal wound reduces the total stay in hospital and the morbidity.     

Mebendazole in the treatment of helminthiasis

Mebendazole, a new broad-spectrum anthelmintic, was used to treat patients with nematode infections--ascariasis, trichuriasis and hookworm. The dosage for adults was 100 mg twice daily for 3 days and for children, 50 mg twice daily for 3 days. Pretreatment and post-treatment egg counts on stool specimens showed that after mebendazole there was a reduction of over 99% in egg count per gram of stool in all three types of infection. The overall cure rates for the infections were as follows: Ascaris lumbricoides, 86.8% (59/68); Trichuris trichiura, 86.0% (37/43); and hookworm, 85.7% (24/28). The drug was equally effective in light and heavy infections. No important side effect was noted with this drug. It is suggested that mebendazole is the drug of choice for trichuriasis and mixed nematode infection.     

The role of neurochemical mechanisms in the pathogenesis of kinetoses and the therapeutic-prophylactic action of drugs]

Experimental and clinical data on the neurochemical and neurohumoral mechanisms underlying the pathogenesis and therapeutic and preventive effects of drugs are generalized. Literature data and the authors' own data concerning drugs used for the prevention and treatment of kinetoses are given. The possible mechanisms of their effect against motion sickness are suggested. New ideas of the means of search for substances possessing vestibuloprotective activity, and the principles of rational pharmacological correction of vestibuloautonomic disorders in motion sickness are discussed.     

National assessment of early elementary teachers perceived self-efficacy for teaching tobacco prevention based on the CDC guidelines

A national random sample of 505 early elementary school teachers completed a 47-item survey to determine their perceived self-efficacy for teaching tobacco prevention education based on the Centers for Disease Control and Prevention guidelines for grades K-3, their training status on tobacco prevention, and their level of teaching about tobacco prevention. Results indicated most of the teachers were female, White, held a bachelor's or master's degree, never smoked, and had not received formal tobacco prevention training. The teachers' scores were high for efficacy expectations, and for outcome expectations. Conversely, for outcome value, teachers ranked tobacco prevention fifth out of six health topics, as the most important health topic to teach elementary students. Also, teachers trained in four tobacco areas or more had statistically significantly higher scores for efficacy expectations than those trained in three or fewer areas. Statistically significant positive associations were also found between years of teaching tobacco prevention and efficacy and outcome expectation scores, and between the amount of time that tobacco prevention was taught during the past school year and outcome value.     

Suppressors of clathrin deficiency: overexpression of ubiquitin rescues lethal strains of clathrin-deficient Saccharomyces cerevisiae

Clathrin-mediated vesicular transport is important for normal growth of the yeast Saccharomyces cerevisiae. Previously, we identified a genetic locus (SCD1) that influences the ability of clathrin heavy-chain-deficient (Chc-) yeast cells to survive. With the scd1-v allele, Chc- yeast cells are viable but grow poorly; with the scd1-i allele, Chc- cells are inviable. To identify the SCD1 locus and other genes that can rescue chc1 delta scd1-i cells to viability, a multicopy suppressor selection strategy was developed. A strain of scd1-i genotype carrying the clathrin heavy-chain gene under GAL1 control (GAL1:CHC1) was transformed with a YEp24 yeast genomic library, and colonies that could grow on glucose were selected. Plasmids from six distinct genetic loci, none of which encoded CHC1, were recovered. One of the suppressor loci was shown to be UBI4, the polyubiquitin gene. UBI4 rescues only in high copy number and is not allelic to SCD1. The conjugation of ubiquitin to intracellular proteins can mediate their selective degradation. Since UBI4 is required for survival of yeast cells under stress and is induced during starvation, ubiquitin expression in GAL1:CHC1 cells was examined. After a shift to growth on glucose to repress synthesis of clathrin heavy chains, UBI4 mRNA levels were elevated > 10-fold, whereas the quantity of free ubiquitin declined severalfold relative to that of Chc+ cells. In addition, novel higher-molecular-weight ubiquitin conjugates appeared in clathrin-deficient cells. We suggest that higher levels of ubiquitin are required for turnover of mislocalized or improperly processed proteins that accumulate in the absence of clathrin and that ubiquitin may play a general role in turnover of proteins in the secretory or endocytic pathway.     

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.