Impact of supplemental home enteral feeding postesophagectomy on nutrition, body composition, quality of life, and patient satisfaction.

The aim of this prospective cohort study is to analyze the impact of supplemental home enteral nutrition (HEN) post-esophageal cancer surgery on nutritional parameters, quality of life (QL), and patient satisfaction. A systematic review reported that over 60% of patients lose >10% of both body weight and BMI by 6 months after esophagectomy. Enteral feeding (EF) is increasingly a modern standard postoperatively; however, the impact of extended HEN postdischarge has not been systematically studied.

The subdural space of the spine: A lymphatic sink? Myodil's last message.

Following the radiological study of a large number of myelograms, starting over 50 years ago when the only clinical contrast medium available to show the contents of the spinal canal was an iodized oil, the author has collected a number of examples where the oil was inadvertently injected into the subdural area, rather than the intended subarachnoid space. By taking follow-up films at various intervals following the inadvertent injection, it has been possible to study the extent to which the subdural space could become visualized from a lumbar injection, the contrast medium sometimes passing to the top of the cervical region and the lower part of the sacrum. Also, the contrast passed outward along the peri-neural lymphatic sheaths or spaces of the issuing spinal nerves, where it might remain for months, and under the influence of gravity it could extend for a considerable way.

Astrocytic hypertrophy: an important pathological feature of chronic experimental autoimmune encephalitis in aged rats.

Experimental autoimmune encephalomyelitis (EAE) was induced in young (2-3 month old), middle-aged (12-13 month old) and geriatric (24-26 month old) Lewis (JC) rats by active immunisation with myelin basic protein (MBP) in complete Freund's adjuvant (CFA). It was found that aged Lewis (JC) rats developed a more chronic form of EAE than younger rats of the same strain, a phenomenon observed in both male and female rats despite males developing more severe disease than females at all ages. Middle-aged recipients also developed more severe disease than young recipients when EAE was induced by the adoptive transfer of lymphocytes from actively immunised young donors, suggesting that disease chronicity in middle-aged animals is a property of the central nervous system (CNS) milieu.

Obstructive, mixed, and central apnea in the neonate: physiologic correlates.

In an attempt to determine physiologic responses to neonatal apnea, we evaluated changes in heart rate and oxygen saturation as measured by pulse oximetry during 2082 episodes of apnea lasting 15 seconds or more in 47 infants less than 34 weeks of gestational age with idiopathic apnea of prematurity. Of these episodes, 832 (39.9%) were central, 1032 (49.

Suppression of active but not passive autoimmune encephalomyelitis by dual cyclo-oxygenase and 5-lipoxygenase inhibition.

Previous research has shown that the dual cyclo-oxygenase and 5-lipoxygenase inhibitor, BW755c suppresses experimental autoimmune encephalomyelitis (EAE). In the present study, the effects of BW755c on both actively and passively induced EAE in the Lewis rat were examined, and also its effect on the accumulation of radiolabeled spleen cells in response to direct injection of tumor necrosis factor into the spinal cord. It was found that BW755c suppressed actively induced EAE but not passively induced EAE nor cytokine-induced cell accumulation in the central nervous system.

Lymphocytes utilise sialylated surface molecules to accumulate in developing lesions of autoimmune encephalomyelitis.

The accumulation of desialylated radiolabelled normal spleen cells and non-neuroantigen specific CD4 T-lymphocytes was measured in the lumbosacral spinal cord of Lewis rats with autoimmune encephalomyelitis (EAE) induced with myelin basic protein in Freund's adjuvant. The labelled cells were preincubated with sialidase and thoroughly washed prior to intravenous injection into rats exhibiting early clinical signs of EAE. Four hours later, the rats were killed and blood and spinal cord samples were radioassayed.

Characterization of airborne mineral dusts associated with farming activities in rural Alberta, Canada.

The dry and windy climate of the Western Canadian prairie provinces, combined with large scale agricultural activities, results in aerosolization or organic and mineral dusts. The purpose of this study was to conduct an environmental and minerological analysis of these dusts in order to estimate the risk for pneumoconiosis in exposed farmer populations. Two districts in central/southern Alberta were chosen for study.

Immediate, long-lasting suppression of autoimmune encephalomyelitis by cell-bound neuroantigen.

When lymphoid cells from rats recovered from experimental autoimmune encephalomyelitis (EAE) were incubated in vitro for 1 hr with myelin basic protein (BP), then washed and transferred along with anti-BP immune serum to naive recipients, those recipients immediately developed a solid, long-lasting resistance to active induction of EAE. To obtain this high level of suppression, both steps of BP-incubation of cells and transfer of immune serum were found to be essential, i.e.

Compliance with the Royal College of Radiologists' guidelines on the use of pre-operative chest radiographs.

Clinical compliance with the Royal College of Radiologists' guidelines on the use of pre-operative chest radiology was examined in a random sample of patients in four hospitals in England and Wales. Pre-operative clinical data were abstracted from medical reports and, in one hospital, from special chest radiograph request forms completed by clinicians. Seventy-five per cent of patients had clinical indications warranting a pre-operative chest radiograph.

Multicentre trial of four strategies to reduce use of a radiological test.

The Royal College of Radiologists' guidelines on the use of pre-operative chest X-rays were implemented for 1 year in four hospitals in England and Wales. The strategies adopted were: (1) the appointment of a utilisation review committee; (2) getting feedback on use to consultants; (3) the introduction of a new chest X-ray request form; or (4) the concurrent reviewing of chest X-ray requests by the radiology department. The lowest level of use (8.

The long-term collection of lymph from single lymph nodes of foetal lambs in utero.

Surgical techniques are described for the long-term collection of lymph from both prescapular efferent lymph ducts of foetal lambs in utero. Lymph ducts in foetal lambs 95 to 136 days post-conception were cannulated with a high rate of success. Lymph flow from the cannulas was not compromised by deliberate primary or secondary challenge of the lymph nodes with a wide variety of antigens, and often continued for long periods after the lambs were born naturally.

The lymph-borne response of foetal lamb lymph nodes to challenge with Brucella abortus in utero.

The cannulated prescapular lymph node of the foetal lamb was challenged with killed Brucella abortus. Usually, both efferent prescapular ducts were cannulated and one node left as a control. Nodes were given primary or secondary challenges with doses of 10(9) - 2 X 10(10) brucella organisms and the lymph-borne response of the nodes followed.

Radiography in the home.

Modern portable x-ray units are light enough to be easily carried to the ill patient in his home; their output is sufficient for radiographs containing useful diagnostic information to be made of the chest, hip, and other regions, especially if a grid is employed. The skull is considered to be beyond the range of this method of examination, because of the long exposure times required, but gross lesions can be demonstrated in the oesophagus and stomach if barium is given. The radiation hazard is not considered to be a contraindication if appropriate precautions are taken.