Osmotic effects of ethanol on lymphocytes.

The alterations in the immune system caused by ethanol appear to be a complex combination of direct and indirect effects. The role of ethanol as an osmolyte has previously been studied in this laboratory with rat splenocytes. In the present study the osmotic effects of ethanol were investigated in lymphocytes from human normal subjects and alcohol abusers.

Leech-borne Serratia marcescens infection following complex hand injury.

Leeches are commonly used in the postoperative course of plastic surgical operations where there is venous congestion in a pedicled or free flap. They provide a temporary relief to venous engorgement whilst venous drainage is re-established. It is known that leeches can carry Aeromonas hydrophila infection, and a second or third generation cephalosporin antibiotic has traditionally been given as prophylaxis against infection.

Head and neck compensation for total body irradiation using opposed laterals.

Using shaped brass compensators that follow the coronal profile of a patient's head and neck, we confirm that adequate compensation can be made to prevent overdosing in these regions when delivering total body irradiation using opposed lateral fields. Initially, these compensators were custom made for each patient, but we have shown that the variation from patient to patient is sufficiently small that individual compensators can be used for a number of different patients without compromising the dose distribution. In a subgroup of 35 patients on whom diode measurements were made, 20 used compensators from the library of approximately 40 compensators made for previous patients and 15 required new compensators to be fabricated.

A simple bacterial bioassay for the measurement of L-glutamine.

The amino acid L-glutamine has been shown to be important to numerous cells in the body. However, the routine measurement of glutamine in biological solutions is complicated by its relative instability, particularly at extremes of pH. We report a simple bacterial bioassay method for the estimation of glutamine, carried out at neutral pH, using an Escherichia coli that is specifically dependent on the presence of glutamine for replication.

Ethanol-induced osmolality changes and lymphocyte proliferation.

While there have been reports on the in vitro effects of ethanol on mitogen-stimulated lymphocyte proliferation, little attention has been paid to whether these effects are mediated by the ethanol molecule per se or the associated hyperosmolality. There is controversy whether ethanol at high concentrations inhibits or has no effect on mitogen-stimulated proliferation of T cells. In this study we sought to distinguish between effects due to ethanol and those related to increased osmolality.

Thunderstorm-related asthma--the epidemic of 24/25 June 1994.

Background: A large epidemic of asthma occurred following a thunderstorm in southern and central England on 24/25 June 1994. A collaborative study group was formed.

Objectives: To describe the epidemic and the meteorological, aerobiological and other environmental characteristics associated with it.

Radioprotection of hematopoietic tissue by fibroblast growth factors in fractionated radiation experiments.

Acidic and basic fibroblast growth factors (FGF(1/2)) myeloprotect mice in single dose total body irradiation (TBI) experiments with a dose modification factor (DMF) of approximately 1.15. CFU-C assay suggests that one of the mechanisms is augmentation of the shoulder of the radiation dose response curve, and thus protection could be greater with fractionation.

Technique of laparoscopic splenectomy with a powered vascular linear stapler.

The spleen may be removed by a laparoscopic technique, although the benefits and associated morbidity of this approach are unknown. This study reports a series of 28 consecutive patients (15 women; median age 39 (range 17-84) years) considered for laparoscopic splenectomy, because of idiopathic thrombocytopenia in 14, human immunodeficiency virus-related thrombocytopenia in seven, autoimmune haemolytic anaemia in four, lymphoma in two and chronic lymphocytic leukaemia in one. In 23 cases dissection was completed laparoscopically, with the patient in the right lateral position, using a four-cannula technique.

An approach to dose measurement for total body irradiation.

Purpose: An approach is proposed to allow the interpretation of diode measurements on patients receiving total body irradiation (TBI) in opposed lateral fields as midplane dose measurements.

Methods And Materials: This technique consists of making measurements on both entrance and exit sides of any ray path along which the midplane dose is desired. The diode on the entrance side is calibrated so that its output is indicative of the dose delivered at the depth of maximum dose along the ray.

Inter-relationships between glutamine and other biochemical and immunological changes after major vascular surgery.

It has been suggested that increased susceptibility to infection sometimes seen following surgery might be related to levels of circulating glutamine. However, previous studies have not investigated the degree of immune cell activation in relation to availability of glutamine after surgery. In seven patients plasma glutamine concentration decreased by about 50% immediately after major vascular surgery, and took 5 days to recover to normal levels.

Comparison of manual and ultrasonographic evaluation of bladder size in patients prior to laparoscopy.

Background: Catheterization of the bladder may reduce laparoscopic complications although an enlarged bladder may be impalpable in overweight patients or following previous lower abdominal surgery.

Methods: This study assessed bladder size by manual examination and transcutaneous ultrasound (US). Consecutive patients (n = 90; median age 55 years [20-85]; 61 females) undergoing laparoscopy were studied prospectively.

Presentation of endometriosis to general surgeons: a 10-year experience.

The presentation and management of 24 patients with endometriosis (median age 34 (range 21-68)years) presenting to general surgeons over a period of 10 years (1985-1994) was reviewed. Patients presented with an abdominal wall swelling related to a previous Pfannenstiel incision (seven patients), umbilical swelling (four), inguinal canal swelling (two), incidentally following appendicectomy (five), terminal ileal obstruction (two), rectal bleeding (two) and urinary symptoms (two). Endometriosis was not suspected in most patients but was confirmed by surgical excision or resection with minimal morbidity.

Transurethral resection of the prostate in 539 patients at a district general hospital.

This study audited length of hospital stay, mortality and morbidity associated with transurethral resection of the prostate (TURP) in a district general hospital over a 4-year period between 1990 and 1993. Five hundred and thirty-nine TURPs (409 benign and 130 malignant; median age 69 years) were carried out, which represented a twofold increase over the 4-year period. Although the mean duration of stay was 5 days, 92.

Persistent electrocardiographic changes after flecainide overdose.

Flecainide acetate is a potent class 1C antiarrhythmic agent, overdosage with which is rare. An overdose is reported in a patient on long-term therapy, resulting in life-threatening arrhythmias and prolonged electrocardiographic abnormalities.

Raised carcinoembryonic antigen level as an indicator of recurrent disease in follow up of patients with colorectal cancer.

Background: Serum carcinoembryonic antigen level is raised in 80% of patients undergoing colonic resection for cancer. Subsequent elevation in the follow-up period may precede signs and symptoms as an indicator of recurrent disease. there is little evidence that "classical" follow up of patients in the general surgical outpatient clinic improves either survival or quality of life.