Preparing the male urethra for transurethral procedures.

The antiseptic and analgesic effectiveness of different preparations of lignocaine gel used prior to flexible cystoscopy were studied in patients recruited over a 12-month period. This random study involved 106 patients in four groups. There appeared to be no difference in bacterial colonisation of the urethra between the groups.

Use of a eutectic mixture of local anaesthetics in the release of preputial adhesions: is it a worthwhile alternative?

Objective: To see if a eutectic mixture of local anaesthetics (EMLA) could be used effectively for the release of preputial adhesions as a day case procedure.

Patients And Methods: A total of 36 consecutive symptomatic children had their preputial adhesions separated under local anaesthetic with EMLA.

Results: The procedure was successful in 27 children.

Long-term prognostic significance of thymidine labelling index in primary breast cancer.

Tumour growth rates, as measured by incorporation of tritiated thymidine, have been reported as being of prognostic importance in breast cancer. We have measured the thymidine labelling index (TLI) of 185 early breast cancers, followed-up for a minimum of 8 years. Above median TLI was associated with higher tumour grade, but not with other prognostic factors.

Attenuating the hypertensive response to laryngoscopy and endotracheal intubation using awake fibreoptic intubation.

Blood pressure and pulse rate measurements were recorded in 35 patients undergoing endotracheal intubation during general anaesthesia (Group A), and 35 patients who had an awake fibreoptic intubation under local anaesthesia (Group B). The mean arterial pressure in Group A rose by a mean of 35 mmHg immediately after intubation, compared with a mean fall of 9 mmHg in Group B. The mean pulse rate in Group A rose by 24 beats per minute (b.

The long term prognostic significance of oestrogen receptor analysis in early carcinoma of the breast.

The long term prognostic significance of oestrogen receptors was assessed in a prospective study of 767 patients presenting between the years 1975 and 1981 with stage 1 and 2 breast cancer treated by mastectomy with either full axillary dissection or nodal sampling. Oestrogen receptor binding was determined by a dextran coated charcoal method and median follow up was 11 years. Oestrogen receptors were present in 396 (54%) of tumours.

Acute rupture of the abdominal aorta from cross clamp injury.

We report a case of rupture of the infrarenal abdominal aorta due to cross clamp injury. The mechanism of injury has been postulated and the literature on clamp injury has been reviewed.

The value of immunoreactive lipase in acute pancreatitis.

We have evaluated a new agglutination test for serum immunoreactive lipase in 24 patients with abdominal pain and hyperamylasaemia. On admission all 20 patients with acute pancreatitis had a positive lipase test, 3 of the 4 patients who did not have pancreatitis had a negative lipase test. The sensitivity of the lipase test on day 1 is 100%, the specificity 96% and predictive value of a positive test is 95.

Methicillin resistant Staphylococcus aureus; the role of antisepsis in the control of an outbreak.

Between February 1983 and September 1985, an outbreak of methicillin-resistant Staphylococcus aureus involving 151 patients and staff occurred in a district general hospital. At its peak, 43 cases occurred in 3 months. Sixty-two patients suffered morbidity and two died.

In vitro thymidine labelling index in primary operable breast cancer.

The in vitro Thymidine Labelling Index (TLI) of 164 primary breast carcinoma was measured. The relationship of TLI to other established prognostic variables was examined, and the rates of of recurrence and survival of groups of women with high and low TLI tumours were compared. Poorly differentiated tumours had significantly greater TLI values but there were no significant associations with tumour size, axillary lymph node status, age and menopausal status or steroid receptor status.

The effect of povidone-iodine irrigation on perineal wound healing following proctectomy for carcinoma.

Fifty-six patients undergoing abdomino-perineal excision of the rectum for carcinoma were randomized to receive twice daily irrigation of the perineal wound with either 1% povidone-iodine (PVP-I) or normal saline for 5 days following surgery. The incidence of perineal wound infection, primary and delayed wound healing and persistent sinus formation was recorded. There was a highly significant reduction in perineal wound infection in the PVP-I group (P less than 0.

Oestrogen receptors and survival in early breast cancer.

Oestrogen receptor status was related to survival in 414 patients with primary breast cancer. Women with oestrogen receptors in their tumours survived significantly longer than those without receptors; this was true for both premenopausal and postmenopausal women and also when the patients were subdivided into those with and without axillary metastases. Patients with axillary metastases and no oestrogen receptors in their tumours had the worst prognosis, while women with axillary metastases and oestrogen receptors had a death rate similar to that of women with no axillary metastases and no receptors.

The evaluation of cefuroxime in the prevention of postoperative infection.

Patients undergoing biliary surgery received either 750 mg cefuroxime i.m. with the premedication and then 8 hourly for 3 days ((group A) or 1.

Ionized calcium in acute pancreatitis and its relationships with total calcium and serum lipase.

Serial measurements of serum amylase, lipase and ionized calcium were made in a prospective study of 17 patients with acute pancreatitis. The mean serum ionized calcium was significantly below the normal range for the first 24 h and had returned to normal after 48 h. There was no correlation between serum ionized calcium and paired calcium corrected for albumin during the first 36 h of the study, but they were correlated for the remainder of the investigation.