Combustion of pneumoperitoneum: a rare danger in the operating room.

Fire or combustion occurring during laparotomy is an uncommon and potentially hazardous event that can be precipitated by the use of surgical energy devices in the presence of enteric gases or exogenous materials present in the abdomen such as alcohol. Oxygen necessary for a combustive event can be increased in the setting of a proximal enteric injury and with higher concentrations of inspired oxygen during anaesthesia. We report on a case of combustion on entry to the abdomen using monopolar diathermy during exploratory laparotomy for gastric antral perforation in the presence of alcohol and enteric gases.

Intestinal ischemia secondary to superior mesenteric venous thrombosis-A case report.

Introduction: Acute mesenteric venous thrombosis is a rare but potentially fatal condition with superior mesenteric vein being the most common site of thrombosis development [1]. It is more common in patients with underlying disorders which cause disruptions to Virchow's Triad of hypercoagulability, stasis and endothelial injury. The disease is often associated with intestinal ischemia in its acute form, further complicating its management.

Unsolicited Patient Complaints Identify Physicians with Evidence of Neurocognitive Disorders.

Objectives: Determine whether words contained in unsolicited patient complaints differentiate physicians with and without neurocognitive disorders (NCD).

Methods: We conducted a nested case-control study using data from 144 healthcare organizations that participate in the Patient Advocacy Reporting System program. Cases (physicians with probable or possible NCD) and two comparison groups of 60 physicians each (matched for age/sex and site/number of unsolicited patient complaints) were identified from 33,814 physicians practicing at study sites.

Intravenous ferric carboxymaltose versus standard care in the management of postoperative anaemia: a prospective, open-label, randomised controlled trial.

Background: Despite increasing efforts in perioperative management, postoperative iron deficiency anaemia persists, and few data are available about the management of this condition. In this study, we aimed to determine whether giving postoperative intravenous iron (in the form of ferric carboxymaltose) improved iron stores, haemoglobin concentrations, and outcomes following surgery.

Methods: We did a prospective, open-label, randomised, controlled study of patients at two centres (a general hospital and a private health-care centre) in Tasmania, Australia, undergoing elective surgery with functional iron deficiency anaemia (haemoglobin 70-120 g/L and ferritin ≤100 μg/L or iron saturation ≤20%), measured at day 1 postoperatively.

Venous thromboembolism in medical patients during hospitalisation and 3 months after hospitalisation: a prospective observational study.

Objectives: This study was conducted to assess the incidence and risk factors for venous thromboembolism (VTE) in a cohort of medical patients both during the period of hospitalisation and following discharge.

Design: This was a prospective observational study to document the risk profile and incidence of VTE posthospitalisation among all medical patients admitted to our institution during the trial period.

Settings: Primary healthcare.

Functional and structural properties of mammalian acyl-coenzyme A thioesterases.

Acyl-coenzyme A thioesterases (Acots) play important cellular roles in mammalian fatty acid metabolism through modulation of cellular concentrations of activated fatty acyl-CoAs. Acots catalyse the hydrolysis of the thioester bond present within acyl-CoA ester molecules to yield coenzyme A (CoASH) and the corresponding non-esterified fatty acid. Acyl-CoA thioesterases are expressed ubiquitously in both prokaryotes and eukaryotes and, in higher order organisms, the enzymes are expressed and localised in a tissue-dependent manner within the cytosol, mitochondria, peroxisomes and endoplasmic reticulum.

Crystallization of the flexible nuclear import receptor importin-beta in the unliganded state.

The transport of macromolecules across the nuclear envelope is an essential eukaryotic process that enables proteins such as transcription factors, polymerases and histones to gain access to the genetic material contained within the nucleus. Importin-beta plays a central role in the nucleocytoplasmic transport process, mediating nuclear import through a range of interactions with cytoplasmic, nuclear and nuclear pore proteins such as importin-alpha, Ran, nucleoporins and various cargo molecules. The unliganded form of the full-length yeast importin-beta has been expressed and crystallized.

[A ten-year retrospective study of patients operated for hypospadias].

Introduction: Retrospectively we evaluated the surgical treatment of all primary operations for hypospadias performed at the Department of Plastic- and Reconstructive Surgery, Herlev University Hospital, over a period of ten years. During this time we changed the concept of surgical procedure from various two-stage techniques to a new one-stage modification (Scuderi's vascularised vertical preputial island flap combined with a triangular flap glanuloplasty and other refinements). Secondly, we evaluated the pre- and postoperative examination.

Nodularin uptake by seafood during a cyanobacterial bloom.

The problem of blue-green algal toxin contamination of recreational waters and drinking water catchments is well described, as is the potential contamination of associated seafood. Algal contamination of Victorian waterways is now a widespread annual occurrence and, in some regions, the intersection of blooms and commercial fishing threatens the food safety of large numbers of people. Toxin levels which produce no observed adverse effect in animal studies were used to derive safe tolerable daily intake levels.

A comparison of rCBF patterns during letter and semantic fluency.

To evaluate the functional neuroanatomies underlying letter and category fluency, 18 normal controls were studied with oxygen-15 water regional cerebral blood flow positron emission tomography. Three counterbalanced conditions each consisted of 6 trials (45 s each): letter fluency (generating words when cued with a particular letter), semantic fluency (generating words when cued with a particular category), and a control condition (generating days of the week and months of the year). Relative to the control, participants activated similar brain regions during both fluency tasks, including the anterior cingulate, left prefrontal regions, thalamus, and cerebellum; reductions were found in parietal and temporal regions.

Context-dependent, neural system-specific neurophysiological concomitants of ageing: mapping PET correlates during cognitive activation.

We used PET to explore the neurophysiological changes that accompany cognitive disability in ageing, with a focus on the frontal lobe. Absolute regional cerebral blood flow (rCBF) was measured in 41 healthy volunteers, evenly distributed across an age range of 18-80 years, during two task paradigms: (i) the Wisconsin Card Sorting Test (WCST), which depends heavily on working memory and is particularly sensitive to dysfunction of the dorsolateral prefrontal cortex (DLPFC); and (ii) Raven's Progressive Matrices (RPM), which may also have a working memory component, but depends more on visuo-spatial processing and is most sensitive to dysfunction of postrolandic regions. We used voxel-wise correlational mapping to determine age-related changes in WCST and RPM activation and developed a method to quantitate and localize statistical differences between the correlation maps for the two task paradigms.

Functional mapping of human sensorimotor cortex with 3D BOLD fMRI correlates highly with H2(15)O PET rCBF.

Positron emission tomography (PET) functional imaging is based on changes in regional cerebral blood flow (rCBF). Functional magnetic resonance imaging (fMRI) is based on a variety of physiological parameters as well as rCBF. This study is aimed at the cross validation of three-dimensional (3D) fMRI, which is sensitive to changes in blood oxygenation, with oxygen-15-labeled water (H2(15)O) PET.

Cognitive activation during PET: a case study of monozygotic twins discordant for closed head injury.

Using positron emission tomography (PET), we studied physiological changes in a patient with frontal lobe damage resulting from closed head injury by assessing his regional cerebral blood flow (rCBF) pattern relative to that of his uninjured monozygotic (MZ) cotwin and against normal variability between cotwins in 10 comparably-aged, uninjured MZ twin pairs. rCBF was measured during the Wisconsin Card Sorting Test (WCST) and a sensorimotor control task. Differences between the index twins in rCBF activation (WCST-control) in regions determined on coplanar MRIs were compared to within-pair differences in the control group using the Z-statistic.

Modified midfacial degloving. A practical approach to extensive bilateral benign tumours of the nasal cavity and paranasal sinuses.

Midfacial degloving is a well-known technique for entering the nasal and paranasal cavities, the rhinopharynx and the base of the skull. We report our experience with a modification of midfacial degloving, applied to two patients with extensive bilateral benign tumours in the nasal cavities and the paranasal sinuses. No rhinoplastic procedure is necessary in this modification, and the access to the upper part of the nasal cavity is improved.

A new tracheostomy tube. III. Bronchofiberoptic examination of the trachea after prolonged intubation with the NL tracheostomy tube.

Recent publications show that severe damage to the trachea is still a problem with high-volume, low-pressure cuffs. The NL tracheostomy tube was used in 86 patients for 3 days to 2 months (mean 16 days). This tube has a high-volume, low-pressure cuff with automatic regulation of the cuff pressure at 3 kPa.

Experience with the deltopectoral flap.

One hundred and three non-delayed deltopectoral flaps were used for head and neck reconstruction in 86 patients. A retrospective analysis to detect factors with negative influence on the reconstruction resulted in two significant risk factors (p less than 0.05): irradiated recipient site and internal location of recipient site.

The deltopectoral flap: a historical review with comments on its role in neurovascular reconstruction.

The history of the clinical, anatomical and haemodynamic aspects of the deltopectoral flap is reviewed, with some comments on its use as a neurovascular flap.

Immediate reconstruction of a resected segment of the lower jaw, using a compound flap of clavicle and sternomastoid muscle.

A brief account is given of the experimental data and the laboratory findings relative to the use of compound bone flaps of clavicle on a pedicle of sternomastoid muscle for restoration of mandibular defects. The clinical data on this method in 18 consecutive patients are presented and discussed.

A new tongue flap for closure of a pharyngo-cutaneous fistula. Case report.

An apparently original version of the several available tongue flaps is presented for the reconstruction of a lateral pharyngo-cutaneous fistula in a patient where several reconstructive attempts after excision for a malignant tumour had failed.