Withdrawal of the aldose reductase inhibitor tolrestat in patients with diabetic neuropathy: effect on nerve function. The Tolrestat Study Group.

A double-blind, placebo-controlled clinical trial was conducted to study the effects of discontinuing tolrestat, an aldose reductase inhibitor, on peripheral sensorimotor diabetic neuropathy. After an average of 4.2 years of continuous tolrestat use, 372 patients were randomly assigned to either placebo or continued tolrestat therapy and were followed for 52 weeks.

Effect of hyperglycemia and the aldose reductase inhibitor tolrestat on sural nerve biochemistry and morphometry in advanced diabetic peripheral polyneuropathy. The Tolrestat Study Group.

Tolrestat is a well tolerated nonhydantoin aldose reductase inhibitor that has been reported to improve nerve conduction in diabetic animals and humans. Its effects on nerve biochemistry and structure have not been studied in patients with diabetic neuropathy. Patients with advanced diabetic neuropathy treated with long-term open-label tolrestat were randomly assigned to continuation on drug treatment or to placebo-controlled drug withdrawal for 12 months.

Effect of intratracheally administered lindane on aldrin and benzo(a)pyrene contents in lungs of rats.

Pretreatment with lindane resulted in inhibition of benzo(a)pyrene hydroxylase activity in the lungs of rats. The enzyme activity tended to return to normal 5 days after the administration of lindane. Studies with benzo(a)pyrene and aldrin indicated reduced elimination of these compounds from the lungs of lindane-treated animals, suggesting that lindane may alter the clearance of certain substances or compounds from lungs.

Vaginal melanoma and the role of regional chemotherapy.

Vaginal melanoma is a rare cancer usually diagnosed as a locally advanced disease. Aggressive surgical management of the primary tumor and local-regional recurrences, combined with the use of adjuvant radiation and chemotherapy, improves disease-free interval and, perhaps, survival times. Techniques of regional chemotherapy allow the delivery of high doses of chemotherapy to the tumor bed, while minimizing systemic toxicities.

Desirability of using buprenorphine and diazepam as an adjunct to atropine in patients undergoing fibreoptic bronchoscopy.

This study endeavours to evaluate the need for sedation in fibreoptic bronchoscopy and response of the patients when sedation is not used. One hundred and five patients divided into three groups of 35 patients each, received buprenorphine (0.3 mg), diazepam (10 mg) and normal saline (0.

Clinicopathological profile of carcinoma of oesophagus at Aligarh.

Forty-seven patients with oesophageal carcinoma were managed in 6 years' time. Average duration of illness was 5.5 months.

Hepatitis in patients with surgical complications of pulmonary tuberculosis.

During last six years, 2250 patients were treated in Cardiothoracic Unit for thoracic complications of pulmonary tuberculosis. During isoniazid/streptomycin/ethambutol treatment, 2 patients out of 710 (0.28%) developed hepatitis.

Cholecysto-cardiac link.

Thirty normotensive patients (ASA class I) and 30 treated hypertensives without any cardiac problem (ASA class II) were subjected to elective cholecystectomy under general anaesthesia. Patients' age ranged from 25-50 yr, and male:female ratio was 1:11. There were significant increases in heart rate and mean arterial pressure in both the groups (P less than 0.

Tension teratothorax--a case report.

Respiratory distress caused by a giant mediastinal teratoma is hitherto unreported. This communication presents the case history of an 8-year-old boy who presented with this serious problem, along with perforation of the chest wall.

Globalization of the pharmaceutical industry: the physician's role in evaluating drug safety.

The trend toward uniformity of drug registration procedures due to imminent European Economic Community globalization has encouraged pharmaceutical companies to conduct studies on a worldwide basis. This standardization of methods will facilitate the "poolability" of efficacy and safety data generated by these international studies into a common database. With the internationalization of the pharmaceutical marketplace, physicians in industry may be required to collect and interpret such reports from all over the globe.

Conservative management of flail chest.

A total of 100 cases of flail chest were studied to find out the efficiency of the anti-lung contusion regimen containing a diuretic, a steroid and an enzyme preparation for some 10 days, along with pad and strapping. There were 80 males and 20 females. Majority (71%) of patients were between 16 and 45 years.

A new role of bronchofibrescope in the removal of unusual intrapleural foreign bodies.

Successful removal of unusual intrapleural foreign bodies (surgical blades) by means of a bronchofibrescope (BFS) passed through the thoracostomy tube tract is reported. The potential role for the use of the fibreoptic bronchoscope for this purpose is emphasized.

Tooth in the bronchus--an unusual foreign body and presentation.

Tooth in right bronchus in a 60-year-old man who presented with recurrent episodes of chest infection, dyspnoea and haemoptysis is a rare clinical entity. The patient was cured after successful bronchoscopic removal of the tooth.

Bilateral simultaneous pneumothorax--a study of 25 cases.

Twenty-five cases of bilateral simultaneous pneumothorax were studied. In children it was mostly postpneumonic, whereas in adults it was tuberculous or traumatic. Prompt intercostal drainage on both the sides supported by antibiotics and/or anti-tubercular drugs, and respiratory physiotherapy was curative on most occasions.

Bilateral traumatic rupture of the diaphragm.

A 3.5-year-old girl sustained compression injury leading to isolated bilateral diaphragmatic rupture with extensive herniation of abdominal viscera into the pleuropericardial cavities. Reduction of the hernia and repair of the defects were readily accomplished through a thoraco-abdominal approach with excellent outcome.

Corrosive pyloric obstruction without oesophageal involvement in children--a report of two cases.

Two children with gastric outlet obstruction without oesophageal involvement secondary to acid ingestion are described. They presented with frequent vomiting along with pain in the epigastrium. The diagnosis was made by barium swallow and barium meal examination.

Corrosive pyloric stenosis--a report of two cases.

Two unusual cases of post corrosive pyloric stenosis in adults are reported. Both the cases were diagnosed clinically and confirmed by barium meal examination. Patients were discharged following anterior gastrojejunostomy.