The right approach to carcinoma of the cardia: preliminary results.

Surgical treatment of carcinoma of the lower oesophagus and cardia can be compromised by technical difficulties associated with inadequate exposure of the operative field. This may lead to anastomotic failure or local recurrence. A simultaneous right abdominothoracic approach to the oesophagogastric junction without division of either the costal margin or diaphragm facilitates access, allowing radical resection and the performance of a safe anastomosis without the necessity of redraping the patient part way through the procedure.

Laparoscopic general surgery.

Laparoscopic cholecystectomy has become the treatment of choice for symptomatic gallstones. The success of this procedure has prompted surgeons to explore the possibility of performing other procedures laparoscopically. This article describes some of these new techniques and discusses the merits of a minimally.

P300, probability, and introverted/extroverted personality types.

Extreme introverted and extroverted subject groups (n = 24 each) containing equal numbers of male and females were assessed with the P300 (P3) component of the event-related potential (ERP). A two-tone auditory discrimination task in which the probability of the target stimulus varied systematically in different conditions (.20, .

The effect of predilatation on coronary angioplasty-induced vessel wall injury.

Fifty-four patients presenting with stenotic lesions in a major coronary artery visually estimated by diagnostic angiography to be greater than 90% but less than 100% were randomized to one of two angioplasty regimens, predilatation (group 1) or no predilatation (group 2). In group 1, the artery was initially dilated with a 2 mm balloon followed by a balloon that was considered by the operator to be the definitive size to fully dilate the target vessel. In group 2, the artery was dilated with a balloon deemed the definitive size to complete the angioplasty procedure.

Recanalization of chronically occluded aortocoronary saphenous vein bypass grafts by extended infusion of urokinase: initial results and short-term clinical follow-up.

Chronic occlusion of saphenous vein aortocoronary bypass grafts is a common problem. Although percutaneous transluminal angioplasty of a saphenous vein with a stenotic lesion is feasible, angioplasty alone of a totally occluded vein graft yields uniformly poor results. Patients with such occlusion are often subjected to repeat aortocoronary bypass surgery.

Surgical options for left-sided large bowel emergencies.

Current choices of operation for left-sided large bowel emergencies have been established by a questionnaire sent to 218 consultant surgeons asking which operation they would perform under varying circumstances for obstructing sigmoid carcinoma and diverticular disease. A 92% response rate was obtained. Hartmann's procedure (with or without a mucus fistula) is the most popular operation for all conditions.

Bronchioloalveolar carcinoma of the lung and congenital cystic adenomatoid malformation.

A case of bronchioloalveolar carcinoma of the lung is described in a 19-year-old man who had had a lobectomy in infancy, for removal of a congenital cystic adenomatoid malformation. It is suggested that congenital cystic adenomatoid malformation may predispose a patient to development of epithelial malignancies of the lung, whereas mesenchymal hamartomas usually are associated with nonepithelial neoplasms.

Relative bioavailability and DNA adduct formation of benzo[a]pyrene and metabolites in the diet of the winter flounder.

1. Radiolabeled metabolites of the carcinogenic polycyclic aromatic hydrocarbon benzo[a]pyrene (BaP) were shown to be absorbed through the diet of the winter flounder, Pseudopleuronectes americanus. 2.

Temperature dependence of rat diaphragm muscle contractility and fatigue.

The diaphragm is a skeletal muscle of mixed fiber type that is unique in its requirement to maintain contractile function and fatigue resistance across a wide range of temperatures to sustain alveolar ventilation under conditions of hypo- or hyperthermia. The direct effect of temperature (15-41 degrees C) on rat diaphragm isometric contractility and fatigue was determined in vitro. As temperature decreased from 37 to 15 degrees C, contraction and relaxation times increased, and there was a left shift of the diaphragm's force-frequency curve, with decreased contractility at 41 and 15 degrees C.

Pretesting a childbirth handbook.

The development of health education materials for pregnant women involves the work of knowledgeable and experienced health professionals, writers, editors, and artists. Frequently, these materials are also extensively reviewed by various experts and organizations prior to publication. Even with all this expert input and review, however, they can miss the mark if they are not deemed appropriate and acceptable by the audience for whom they were created.

Cardiac amyloidosis causing ventricular tachycardia. Diagnosis made by endomyocardial biopsy.

In patients with malignant ventricular arrhythmias, endomyocardial biopsy may be helpful when all other findings from the workup are negative. A case of nonsustained polymorphic ventricular tachycardia is presented. The findings from an echocardiogram, coronary angiogram, and cardiac catheterization were negative.

Further evidence for a central nervous system component in equine laryngeal hemiplegia.

Evidence for a central nervous system component of the distal axonopathy associated with equine laryngeal hemiplegia was found in this survey of 33 horses (control, 15; subclinical, 8; clinical, 10). Significantly higher numbers of axonal spheroids were present in sections of the lateral cuneate nuclei in layngeal hemiplegic horses than in those unaffected by the disease.

Sutures for inguinal herniorrhaphy--a comparison of monofilaments with PTFE.

Polybutester (Novafil, Davis & Geck) and expanded polytetrafluoroethylene PTFE (Gore-tex, W L Gore) were compared with nylon (Ethilon, Ethicon UK) for elective inguinal herniorrhaphy. PTFE had the best handling characteristics, but is expensive, and increased wound sepsis attended its use. Polybutester had significantly better handling characteristics, and is an attractive alternative to nylon for hernia repair.

Structure of the human CR1 gene. Molecular basis of the structural and quantitative polymorphisms and identification of a new CR1-like allele.

Structural and quantitative polymorphisms have been described in human CR1. In the former, the S allotype is larger than the F allotype by 40-50 kD, the size of a long homologous repeat (LHR). In the latter, homozygotes for a 7.

A system approach to intravenous thrombolysis in acute myocardial infarction in community hospitals: the influence of paramedics.

Unlabelled: During a 3-year period, intravenous streptokinase (IV STK) was given to 110 consecutive patients ages 34-78 in the course of acute myocardial infarction (AMI) in three community hospitals served by the same paramedic system. 1.5 million units of IV STK was given over 30 minutes.