Verapamil attenuates stress-induced gastric ulceration.

Since many of the proposed etiologic factors leading to gastric stress ulceration involve stimulation of calcium influx, the effect of verapamil, a potent calcium channel blocker, on the gastric mucosa in cold-restrained inbred rats was assessed. Twenty-nine rats received intraperitoneal normal saline (2 ml) while the experimental group (N = 29) received 1 mg/kg verapamil in an equal volume of normal saline intraperitoneally. All animals were then stressed at 4 degrees C for 4 hr and sacrificed.

High fibre diet in symptomatic diverticular disease of the colon.

Over the past decade fibre supplementation has achieved widespread acceptance in the management of symptomatic diverticular disease, although the efficacy of this treatment has been debated. We have conducted a retrospective review of 72 patients admitted to hospital with symptomatic diverticular disease over a ten year period in order to determine whether or not high fibre diet afforded protection against the development of complications, necessity for surgery or persistence of symptoms. Fifty-six patients were treated non-operatively, of these 43 received advice concerning a high fibre diet but only 31 patients complied.

Ultrasonography, HIDA scintigraphy or both in the diagnosis of acute cholecystitis?

The benefit of early surgery for patients with acute cholecystitis is now accepted but rapid accurate pre-operative diagnosis is important and the single best investigation has not yet been clearly established. All 47 patients with suspected acute cholecystitis admitted to a district general hospital during a 6 month period underwent ultrasonic examination and scintigraphy with HIDA within 48 h of admission. In 23 patients acute cholecystitis was proven.

Choledochoscopy? Post-exploratory fluorocholangiography? Or both?

Per-operative, post-exploratory fluorocholangiography and choledochoscopy were evaluated prospectively in 59 consecutive patients undergoing bile duct exploration for calculus disease. Fluorocholangiography showed filling defects in 13 cases and was valuable in localisation of stones, assessment of ampullary patency and visualisation of intrahepatic radicles. Choledochoscopy confirmed stones in nine cases, gave immediate confirmation of four false positive X-rays, enabled removal of five residual stones and biopsy of one benign stricture.

Lymph node imprint cytology for the rapid assessment of axillary node metastases in breast cancer.

Lymph node imprint cytology was performed on 86 nodes from 13 consecutive patients with breast cancer undergoing simple mastectomy with axillary node sampling, and a prospective comparison with paraffin section was made. The results showed a diagnostic sensitivity and specificity of 0.93 and 0.

Discitis as a cause of abdominal pain in children.

The purpose of this study is to draw attention to inflammatory disease of lumbar intervertebral discs in children as a source of referred abdominal pain. For three children presenting with abdominal pain the eventual diagnosis was discitis of the lumbar spine. Failure to examine the patient's backs at the initial examinations resulted in a delay in diagnosis ranging from 66 to 2 days.