Performing internal sphincterotomy with other anorectal procedures.

Purpose: A study was conducted to compare the outcome of combined anorectal procedures involving lateral internal sphincterotomy with lateral internal sphincterotomy alone to determine if the former results in increased complications.

Methods: Complications and anal function of 57 patients who underwent lateral internal sphincterotomy for chronic anal fissure in conjunction with another anorectal procedure (combined group) between April 1989 and June 1992 were compared with 57 other age- and sex-matched patients who underwent lateral internal sphincterotomy alone (control group).

Results: There was no statistical difference in the incidence of incontinence in the combined group (8.

Selective sedation for colonoscopy.

A study of selective sedation for colonoscopy was conducted in two parts. All procedures were performed by one experienced colonoscopist. In the first phase, 41 patients received intravenous sedation before colonoscopy and were then prospectively randomized to either a "not-reversed" group, which did not receive flumazenil before withdrawal of the colonoscope, or to a "reversed" group, which received flumazenil before colonoscope withdrawal.

Life table analysis of stomal complications following colostomy.

Purpose: This study was designed to evaluate the long-term complication rate of left iliac fossa end sigmoid colostomies and to determine etiologic factors.

Methods: A retrospective chart review and actuarial analysis were performed.

Results: The crude and actuarial risks of paracolostomy complications in 203 patients were 51.

IgG-mediated phagocytosis in regenerated splenic tissue.

The risk of severe infections after splenectomy is well established. Operations such as auto-transplantation, splenic artery ligation or partial resection have been advocated for the retention or regeneration of splenic tissue following splenic trauma. The potential of such tissue to protect from infection is unclear.

Nuclear shape and prognosis following orchiectomy in stage D2 prostate cancer.

In this study, we have examined whether tumor grade and morphometric nuclear features can predict the outcome of treatment by orchiectomy in patients with stage D2 prostate cancer. Two outcome groups based on duration of survival postorchiectomy were examined, a bad outcome group of 63 patients who died from prostate cancer within 12 months and a good outcome group of 34 patients who survived beyond 5 years. Tumors were histologically classified as well (17%), moderate (17%), or poorly differentiated (66%).

Life-table analysis of stomal complications following ileostomy.

Stomal complications of ileostomy may occur many years after construction. An actuarial analysis of complications of 150 permanent end ileostomies constructed over a 10-year period is reported. By 20 years the incidence of stomal complications approached 76 per cent in patients operated on for ulcerative colitis and 59 per cent in those with Crohn's disease (P < 0.

Dual staining of lymphocyte membrane antigens with colloidal gold and biotinylated horseradish peroxidase.

Double immunoenzymatic labelling procedures for the localization of antigens on cells in tissue sections using horseradish peroxidase (HRP) and alkaline phosphatase have been described previously, but mainly for detecting antigens on different cells. With this type of staining when two antigens are present on the same cell, an optimal colour combination that shows a high contrast between the basic colour of each enzyme substrate product is difficult to achieve and the interpretation of their mixed colour intermediate is subjective. We present a method for the simultaneous demonstration of two antigens on the same cell.

Colorectal cancer and intestinal tuberculosis.

Intestinal tuberculosis occurring together with colorectal cancer is an uncommon event and presents an interesting patho-aetiological relationship. Four cases of abdominal tuberculosis occurring together with colorectal cancer are presented. There were three males and a female.

Results of a policy of selective immediate fistulotomy for primary anal abscess.

A prospective study of a policy of selective immediate fistulotomy in the management of acute primary anal abscesses was performed. Eighty-nine patients (74%) underwent simple drainage only, as no internal openings were found during drainage of pus (group A). Thirty-one patients (26%) had drainage of pus and immediate fistulotomy (group B).

Chronic Pseudomonas aeruginosa endobronchitis in rhesus monkeys: II. A histopathologic analysis.

We have recently established a rhesus monkey model of chronic Pseudomonas aeruginosa (PA) endobronchitis by bronchoscopic instillation of PA-embedded agar beads. All experimental animals developed chronic neutrophilic endobronchitis similar to chronic PA endobronchitis in cystic fibrosis (CF). Histopathologic studies further confirmed similarities to chronic PA endobronchitis in CF, including marked peribronchial inflammation, epithelial damage, presence of degraded cilia and ciliary abnormalities, appearance of PA bacterial clusters, mucosal hyperplasia, goblet cell hypertrophy/hypersecretion, airway obstruction, alveolar abnormalities, bronchiectasis, and fibrosis.

Two haemangioendotheliomas in a bovine brain.

The microscopical, ultrastructural and immunohistochemical features of an unusual type of haemangioendothelioma in the brain of a calf are described. The salient features of this tumour were an exuberant proliferation of vasoformative elements whose endothelial cells exhibited epithelioid and spindle cell features. Intracytoplasmic miniature lumen formation in endothelial cells was characteristic of this vascular neoplasm.

Laminin and type IV collagen in experimental rat oral carcinomas.

The pattern of staining and the distribution of laminin and type IV collagen in normal rat tongue mucosa and induced tongue carcinomas were investigated by immunohistochemical techniques. Both normal and neoplastic epithelial basement membrane revealed positive staining for laminin and type IV collagen. However, compared with normal tissue, carcinomas exhibited areas of increased density and thickness for laminin.

Microwave techniques for diagnostic laboratories.

Microwaves (MWs) were first introduced as a method of fixation just over 20 years ago. In recent years their use has extended far beyond that of a safe, clean and rapid method of fixation of tissue blocks and large specimens, including brains. MWs accelerate the action of cross-linking fixatives and can greatly accelerate the various stages of tissue processing to produce a paraffin block in 30 min.

Extradural malignant lymphoma associated with spinal cord compression.

Cord compression was noted in 26 patients with extradural malignant lymphoma. There were 19 cases of nonHodgkin's lymphoma and seven cases of Hodgkin's disease. Eighteen cases of non-Hodgkin's lymphoma had intermediate or high grade malignancy types according to the Working Formulation Lymphoma Classification.

The vascular supply of splenic autotransplants.

The close opposition of blood to phagocytic cells lining the pulp cords and marginal sinus has been proposed as a contributing factor in the clearance mechanism of the spleen. The vasculature of splenic autotransplants was investigated in rats using microcorrosion casts. Six-month-old splenic autotransplants and unoperated control spleens were selectively perfused and a methyl methacrylate cast was made.

Small cell (neuroendocrine) carcinoma of the vagina.

We report a case of vaginal small cell (neuroendocrine) carcinoma. Immunostaining for neuron-specific enolase, PGP 9.5, chromogranin, synaptophysin, Leu 7 and cytokeratin was positive.

The role of the surgical pathologist in the examination of the non-palpable breast lesion.

The specimen excised for the mammographically detected lesion is somewhat unique and requires special consideration by the surgical pathologist. The biopsy, in most instances, contains no grossly visible lesion and is relatively large so that blocking in its entirety is not practical. The pathologist needs to establish that the radiological abnormality is contained in the biopsy and to this end specimen radiography is required.

Gross handling of impalpable breast lesion specimens.

The growing use of mammography has resulted in increasing numbers of impalpable breast lesion specimens requiring histopathological assessment. The examination of such specimens may be very time-consuming as multiple levels of many tissue blocks may need to be studied. Two grid localization methods are compared with a serial slicing method in an attempt to determine an efficient manner of identifying the impalpable lesion, and thus minimizing unnecessary processing.

A retrospective analysis of immunohistochemical staining in identification of poorly differentiated round cell and spindle cell tumors--results, reagents and costs.

Immunohistochemistry has rapidly established a significant role in diagnostic pathology. We use immunohistochemistry as an adjunct to morphological diagnosis and employ a "panel approach" to the classification of poorly differentiated tumors. This retrospective analysis was conducted to examine the efficacy of such an approach, using, as an example, the two most common categories of poorly differentiated tumors, namely, the poorly differentiated round cell tumors and spindle cell tumors.

Chronic Pseudomonas aeruginosa endobronchitis in rhesus monkeys: I. Effects of pentoxifylline on neutrophil influx.

Host defense abnormalities in cystic fibrosis (CF) against Pseudomonas aeruginosa (PA) lead to excessive neutrophil influx into the infected lungs, resulting in pulmonary complications. We have developed a rhesus monkey model of chronic PA endobronchitis by intrabronchial instillation of PA-embedded agar beads, utilizing flexible fiberoptic bronchoscopy. Treatment of infected monkeys with pentoxifylline suppressed neutrophil influx and ameliorated pulmonary damage.