Laparoscopic appendectomy: three years' experience.

Laparoscopic appendectomy was performed on 109 patients over a 3-year-period--1988 to 1991. All procedures were uneventful and all patients resumed normal activity within a shorter period than had been experienced with open appendectomy. Patients had a superior cosmetic result and experienced significantly less postoperative discomfort.

Putative chromaffin cell survival and enhanced host-derived TH-fiber innervation following a functional adrenal medulla autograft for Parkinson's disease.

We report heretofore undescribed clinical and histological features of a patient with idiopathic Parkinson's disease who showed marked and persistent motoric benefit from an adrenal medulla autograft for 18 months following grafting. The patient returned to the preoperative level of disability prior to his death 30 months after implantation, the longest survival to date for an adrenal transplant. The graft site was primarily necrotic and large numbers of macrophages were still present at the time of death.

Comparison of a noninstrumented immunoassay for carbamazepine to high performance liquid chromatography and fluorescence polarization immunoassay.

The accuracy, precision, and potential clinical utility of a new whole blood, noninstrumented immunochromatographic assay (AccuLevel) for carbamazepine (CBZ) was evaluated in a multicenter trial including 100 pediatric and 205 adult patients. The AccuLevel assay, a fluorescence polarization immunoassay (FPIA), and high-performance liquid chromatography (HPLC) were used to determine CBZ concentration in samples from 111 female and 194 male patients aged 2-72 years (median 25 years). Mean +/- SD plasma CBZ concentrations in all patients were 7.

Inability of inline pressure monitoring to predict or detect infiltration of peripheral intravenous catheters in infants.

Monitoring of inline intravenous pressure as a method for predicting or detecting infiltration of peripheral catheter sites in infants was evaluated. Inline intravenous pressure was measured every 30 minutes in infants less than 12 months of age who had standardized peripheral catheters through which they were receiving a continuous infusion. Pressure was measured by an inline pressure transducer, and the signal was recorded by a strip chart recorder.

Effect of the continuous administration of fat emulsion on the infiltration of intravenous lines in infants receiving peripheral parenteral nutrition solutions.

Animal data and anecdotal human experience suggest that vascular damage induced by the infusion of dextrose/amino acid solutions may be ameliorated by the concomitant administration of fat emulsion. We prospectively evaluated the effect of the continuous infusion of peripheral nutrition solutions with and without fat emulsion on the incidence of, probability of, and time to infiltration of peripheral venous lines in infants (median age: 1.0 month; range 1 day-11.

Parenteral nutrition in the critically ill patient.

The metabolic alterations, nutritional and metabolic assessment, and nutritional requirements of critically ill patients are discussed, and parenteral nutrition support therapies are reviewed. Physiological alterations in the metabolism of the injured or septic patient are mediated through the interactions of neuroendocrine, cardiovascular, toxic, and starvation responses. These responses cause mobilization of nutritional substrates in an effort to maintain vital organ function and immune defenses.

Combining multiple-subaperture and two-wavelength techniques to extend the measurement limits of an optical surface profiler.

A method has been developed for extending the measurement range of an optical surface profiler using the techniques for combining multiple subapertures and two-wavelength phase-shifting interferometry. The effective trace length of the optical profiler is augmented by making a series of partially overlapping collinear measurements and then piecing the subapertures into a composite profile, thus extending the field of view of the instrument. The vertical dynamic range of the optical profiler is extended by taking phase measurements at two wavelengths and then subtracting these measurements to obtain the same result as if the object had been tested at a longer equivalent wavelength.

Parenteral nutrition in pediatric patients.

Protein, calorie, fluid, fat, and micronutrient requirements of pediatric patients are reviewed, as are methods of nutritional assessment and complications associated with the use of parenteral nutrition in these patients. In general, preterm infants and neonates require greater per-kilogram amounts of protein, calories, fluid, and micronutrients than older children. In addition, preterm infants and neonates have deficiencies in enzymes that metabolize certain amino acids, making otherwise nonessential amino acids essential.

The influence of gestational age and preeclampsia on the presence and magnitude of serum endogenous digoxin-like immunoreactive substance(s).

Digoxin-like immunoreactive substance(s) has been measured in serum during pregnancy. Because of its presence in pregnancy, investigators have suggested that digoxin-like immunoreactive substance may play an etiologic role in the development of preeclampsia. The objectives of this study were to evaluate the relationship between maternal digoxin-like immunoreactive substance and gestational age and compare digoxin-like immunoreactive substance concentrations in patients with and without preeclampsia who were in the third trimester.

Digoxin-like immunoreactive substance in pregnancy.

Our aims were to determine the potential usefulness of digoxin-like immunoreactive substances in the prediction of preeclampsia, to study the relationship between fetal production of these substances and maternal serum levels, and to evaluate the association between digoxin-like immunoreactive substances and plasma volume findings in preeclamptic pregnancies. Serum digoxin-like immunoreactive substance concentrations were measured in normotensive and preeclamptic pregnant women and in umbilical artery and vein blood samples. None of the patients in the first trimester (n = 53) and 11% of those in the second (n = 56) had detectable levels of this substance.

Perceptual information for batting can be extracted throughout a ball's trajectory.

Studies of batters' eye movements have demonstrated that batters do not (or cannot) maintain fixation on the ball throughout its trajectory. In addition, the velocity of a pitched ball, together with the limitations of human reaction time, seems to imply that only the first portions of the ball's trajectory provide information to batters. We prevented nine experienced fast pitch softball players from viewing the ball during the first, middle, or last third of its trajectory and found that seeing the first third of the ball's trajectory is not as critical as had been thought: batters are very good at making do with whichever two-thirds of the ball's trajectory is visible.

Transient global amnesia after cerebral angiography. Report of seven cases.

Because of a case of typical transient global amnesia following cerebral angiography, the records of all patients undergoing cerebral angiography during a seven-year period were reviewed. Six other cases were discovered. All patients had either transfemoral catheter or brachial angiograms performed immediately before the development of amnesia.