Initial experience on efficacy in closure of cryptoglandular and Crohn's transsphincteric fistulas by the use of the anal fistula plug.

Background And Aims: It was the aim of this prospective study to analyze the efficacy of the Cook Surgisis AFP anal fistula plug (AFP) for the closure of cryptoglandular and Crohn's disease-associated transsphincteric anorectal fistulas.

Materials And Methods: All patients with transsphincteric anorectal fistulas who underwent a surgical procedure using the AFP were prospectively enrolled in this study. Inclusion criteria included transsphincteric, single-tract fistulas.

Survey of inpatient counseling by hospital pharmacists.

A survey was conducted to determine the inpatient-counseling practices of hospital pharmacists. A questionnaire about the frequency of inpatient counseling, barriers to counseling, and suggestions for increasing the level of inpatient counseling was mailed to 667 hospital pharmacists. Recipients were asked to rate six attitudinal statements about inpatient counseling.

Influence of blood transfusions on tumor recurrence and survival rate in colorectal carcinoma.

Determinants for homologous blood transfusion and its influence on postoperative and long-term results were evaluated in 439 curatively resected colorectal cancer patients. The rate of transfusion was significantly higher in rectal cancer, large tumors, advanced pT stage and extended resection but not in tumor stenosis, lower graded tumors, advanced Dukes stage or less experienced surgeons. Transfused patients showed significantly more postoperative complications, higher recurrence rates as well as less favorable long-term survival.

Intracellular pH, esterase activity, and DNA measurements of human lung carcinomas by flow cytometry.

An important intention of flow cytometric investigations is to obtain biochemical and biophysical information about cells which is suitable for automated tumor diagnosis. In this study, the ploidy status, the intracellular pH value, the intracellular esterase activity, and the cell volume of vital cells and the DNA and cell volume of dead cells were measured in cancerous tissue and normal lung tissue of 30 patients by flow cytometry. The cell samples were simultaneously stained with the pH and esterase indicator dye 1.

[Effect of blood transfusion on tumor recurrence and rate of survival in colorectal cancer].

In 439 curatively resected colorectal cancer patients determinants for homologous blood transfusion and its influence on postoperative and long-term results were evaluated. The rate of transfusion was significantly higher in women, rectal cancers, large tumors, advanced pT-stage and extended resections but not in tumor-stenosis, lower graded tumors, advanced Dukes-stage or less experienced surgeons. Transfused patients showed significantly more postoperative complications, higher recurrence rates as well as less favorable long-term survival.

Effects of repeated injection sclerotherapy on acid gastroesophageal reflux.

Acid gastroesophageal reflux was determined by long-term pH monitoring in 19 consecutive variceal bleeders after 5 to 20 (mean, 10.3 +/- 1 SEM) sclerotherapy sessions with the flexible endoscope using polidocanol 1% as sclerosant. Fifteen cirrhotics with untreated varices served as controls.

[Reconstruction of esophageal passage in functional disorders (achalasia, Zenker diverticulum, spasms)].

Before removing the diverticula (running suture for mucosa, interrupted stitches for the esophageal wall with resorbable material) a myotomy of the upper sphincter (pars inf. of the crycopharyngeal) muscle should be performed to restore the preoperative insufficient relaxation of the upper sphincter. The diffuse spasm shows a normal function of the LES; painful attacks can be treated by calcium antagonists or nitroglycerin.

Automated flow-cytometric identification of colo-rectal tumour cells by simultaneous DNA, CEA-antibody and cell volume measurements.

A new method for the automated flow-cytometric identification of colo-rectal tumour cells was developed. Fresh tissue is cut mechanically to obtain single cell suspensions. The cells are then incubated with antibodies in an indirect immunofluorescence assay for CEA (carcino-embryonic antigen) on the cell surface, and counterstained with the DNA stain propidium iodide.

Guidelines for planning home enteral feedings.

Tube feeding at home is a viable option for maintaining optimum nutriture when oral intake is inadequate or impossible. Qualifying patients and their caretakers can be instructed in formula preparation, feeding administration, and related care techniques. Extra hospital support systems, including insurance agencies, home medical suppliers, and public health nurses, are available to facilitate the transition from hospital to home care.

Esophageal function after sclerotherapy of bleeding varices.

To study the effect of sclerotherapy of varices on esophageal function, the motility of the tubular esophagus and of the lower esophageal sphincter (LES) were recorded in 19 patients after 7 to 13 sclerotherapy sessions and in 15 healthy volunteers. In addition, esophageal functional scintigraphy (EFS) was performed in the patient group. Compared with the volunteers the patients had lower contraction amplitudes in the distal esophagus (30.

[Islet cell cancer with organic hyperinsulinism. Clinical aspects, diagnosis and therapy].

About 8%-15% of the patients with organic hyperinsulinism have an islet cell carcinoma (13% in our series). In addition to a history of complaints of relatively recent onset, the patients present clinically the typical intermittent neurologic-psychiatric symptoms concurrently associated with hypoglycemia. The diagnosis is established biochemically on the basis of hypoglycemia, with inadequate incrementation of the insulin concentration subsequent to suppression and provocation tests.

Indication for, and valuation of computed tomography following anterior resection of the rectum.

During a controlled study, 55 patients who had an anterior resection of the rectum were thoroughly examined, including by computed tomography. The results verified the following statements: 1. The use of CT as a screening-method for early detection of local tumour recurrence following anterior resection of the rectum appears not to be justified.

[The angiographic diagnosis of islet cell tumours. Results in 34 patients (author's transl)].

Between 1965 and 1979, 34 patients with organic hyperinsulinism were examined angiographically. By observing the following points it should be possible to diagnose tumours greater than 1 cm, whatever their position in the pancreas: 1) Use of high performance generators and tubes which permit one to employ fine focus, low kv and high mAs. 2) Optimum imaging systems (carbon fibre table top, high intensity screens).

[Clinical aspects, diagnosis and treatment of organic hyperinsulinism. Experience with 46 operated patients (author's transl)].

The clinical picture of organic hyperinsulinism is presented with reference to experience in 46 operated patients. For the recognition of disease, a careful history is a decisive contribution. The hunger test showed a characteristic hypoglycemic reaction in 100%; the tolbutamide test gave a positive result in 92%.

Grain count threshold dependence of FLM curve pattern and cell cycle parameters of hepatocytes in vivo.

FLM curves from hepatocytes of regenerating rat liver in vivo were compared at different grain count thresholds. Estimates of cell cycle phases derived from curves with thresholds decreasing from 15 to 1 grain (background 0-2 grains per nuclear area) revealed a prolongation of ts from 6-6 to 9-5 hr, at the expense of tG2M, and tG1, whereas tc remained constant. A similar pattern was observed in FLM curves at various threshold levels for hepatocytes localized in subunits of the liver lobule along the vascular axis from afferent to efferent pole.