Experiences with an artificial sphincter to establish anal continence in dogs.

An implantable device for establishing urinary continence has been developed and has received FDA approval (AS 800, American Medical Systems, Inc.). The authors have applied this device to the control of anal continence in dogs.

Rapid control of hemorrhage of the scalp in the patient with trauma.

The use of Leroy-Rainey clips is rapid and effective in controlling extensively bleeding wounds of the scalp. They are a valuable aid in assessment and stabilization of patients with trauma.

Tube thoracostomy and trauma--antibiotics or not?

Controversy persists regarding the use of antibiotics in association with t tube thoracostomy for trauma patients. We conducted a prospective randomized study of patients requiring tube thoracostomy for pneumo- and/or hemothorax complicating blunt or penetrating thoracic trauma in an attempt to assess the efficacy of prophylactic antibiotic therapy. Fifty-eight patients were included in the study.

A nonheparinized muscle model for studies of ischemia-reperfusion injury.

An understanding of the basic metabolic, functional, and histologic features of skeletal muscle injury secondary to ischemia and reperfusion has thus far been hampered by the lack of an adequate animal model. We have developed an in vivo isolated skeletal muscle preparation amenable to ischemia-reperfusion studies and the investigation of therapeutic modalities. The model is autoperfused and, most importantly, nonheparinized.

Surgical management of bleeding esophageal varices. Results with 80 cases.

This report presents results of surgery for bleeding esophageal varices in 80 patients. A prospective randomized study addresses the efficacy of the distal splenorenal shunt (DS) versus the mesocaval shunt (MS) in 50 patients undergoing elective surgery. An additional 30 patients underwent emergency MS for uncontrollable hemorrhage.

The Eck-Pavlov connection.

In 1877, N. V. Eck described the surgical creation of a fistula between the inferior vena cava and the portal vein in a dog.

Effects of vasopressin on cardiac output and its distribution in the subhuman primate.

The effects of vasopressin, when administered as intravenous bolus injections and infusions, on cardiac output and the distribution of blood flow to the splanchnic vascular beds were studied in six anesthetized rhesus monkeys. Vasopressin as bolus injections caused dose-dependent decreases in superior mesenteric arterial blood flow. However, small reductions in cardiac output were observed only at the highest doses concomitant with increases in systemic arterial pressure.

Hemodynamics of an anastomotic arteriovenous fistula.

Various vascular surgical techniques have been employed to increase both graft patency and limb survival when the prognosis for limb salvage in arteriosclerotic patients is especially poor due to a diseased outflow tract. Ibrahim et al described the creation of an anastomotic arteriovenous fistula in distal tibial bypasses as the reconstructive procedure of choice in severely ischemic extremities unsalvageable by more conventional methods. This study presents the hemodynamics of an anastomotic arteriovenous fistula under such circumstances.

Changing attitudes toward management of cancer of the colon and rectum.

Changes in the attitudes of surgeons toward the management of cancer of the colon and rectum over a 5-year period were assessed by analysis of responses of general surgeons to a 21-item questionnaire on colon cancer from 1978 and 1983. Comparisons of the responses revealed that the use of routine preoperative liver scans has decreased from 57 to 45 per cent. Transanal resection of villous adenoma of the rectum is used more often (44% in 1983 versus 34% in 1978).

Interval breast cancer: a more aggressive subset of breast neoplasias.

It has been suggested that interval breast cancer (breast cancer found within 12 months of a negative screening examination) exhibits a more virulent behavior than those found by the screening clinic. To test this hypothesis, 120 new cases of breast cancer were retrospectively reviewed from our Breast Screening Center. These patients were divided into three groups--interval cancer cases, lesions found at initial screening, and lesions found at subsequent screening.

The U.S. M-16 rifle versus the Russian AK-47 rifle. A comparison of terminal ballistics.

The standard U.S. military rifle (M-16) is substantially more destructive than its Russian counterpart (AK-47) when fired at short range into clay blocks, despite the fact that the AK-47 is of larger caliber and fires a much heavier bullet with a kinetic energy (muzzle) 25% greater when compared to the M-16.

Current attitudes in the management of thyroid cancer.

The opportunity to assess the current attitudes of surgeons in the management of thyroid cancer was afforded by the responses to a questionnaire that was part of a "Questionnaire Course." The majority of the 72 respondents have a conservative surgical approach to thyroid cancer, find frozen section useful, recommend total thyroidectomy for medullary cancer, seldom or never split the sternum in performing thyroidectomy, and recommend visualization of the recurrent laryngeal nerves and the parathyroids. Opinions however, are divided on several other issues.

The "unrecognized" spigelian hernia.

The appearance at a community hospital of four cases of spigelian hernia within a 16-month period lends support to the supposition that this lesion is more common than reports would indicate. Main points to consider in establishing the likelihood of this condition primarily include an awareness of its existence and its multiple symptomatology, the anatomic schema of the lateral rectus border, careful abdominal examination and use of radiographic aids.