Disconnection of Cobe SMARxT tubing from the venous outlet of the Terumo Capiox SX25RX oxygenator during cardiopulmonary bypass.

The use of surface modified, biocompatible tubing in cardiopulmonary bypass has been reported to decrease the inflammatory responses caused by blood contact with the non endothelial surface of poly vinyl chloride (PVC) tubing. The combination of advances in biocompatible tubing and increased affordability resulted in a change to our cardiopulmonary bypass circuit, with the Terumo Capiox SX25 oxygenator and Cobe PVC tubing being replaced with a Terumo Capiox SX25RX (with X coating) and Cobe SMARxT tubing. Prior to the introduction of the coated oxygenator, no connection problems had been evident.

A mimicry of an acute coronary syndrome.

Background: A 79-year-old woman was out in the garden having lunch on a hot summer day. She developed stabbing chest pains, more severe on her left side, associated with radiation down her left arm. Severity was 7 out of 10.

A mimicry of an acute coronary syndrome.

Background: A 79-year-old woman was out in the garden having lunch on a hot summer's day. She developed stabbing chest pains more severe on her left side, associated with radiation down her left arm. Severity was 7 out of 10.

Reduction in late diagnosis of colorectal cancer following introduction of a specialist colorectal surgery service.

Introduction: An audit of patients presenting with colorectal cancer to our district general hospital during a 2-year period from November 1994 found that 12.1% of cases were diagnosed later than 6 months after initial presentation to a physician. This audit was repeated for a 2-year period from December 2001, to determine whether the introduction of a specialist coloproctology surgery service had led to a reduction in late diagnosis of colorectal cancer.

The future of the perfusion record: automated data collection vs. manual recording.

The perfusion record, whether manually recorded or computer generated, is a legal representation of the procedure. The handwritten perfusion record has been the most common method of recording events that occur during cardiopulmonary bypass. This record is of significant contrast to the integrated data management systems available that provide continuous collection of data automatically or by means of a few keystrokes.

Ease of removal of thermo-expandable prostate stents.

Objective: To report the ease of removal of the Memokath 028 prostatic stent (Engineers & Doctors A/S, Hornbaek, Denmark), an important attribute of the 'ideal' prostatic stent.

Patients And Methods: Data on patients who had had a Memokath 028 stent removed in three different centres in Europe over an 8-year period were collected retrospectively. Standardized forms were used to record relevant information from each physician's patient files.

Ectopic pregnancy - laparoscopic management in a district general hospital.

A 2-year retrospective study was carried out in a district general hospital to review the outcome of laparoscopic management versus laparotomy for the management of ectopic pregnancy. Outcome measures included operating time, postoperative analgesia requirements, complications, length of hospital stay, the post-ectopic intrauterine pregnancy rates and the recurrent ectopic pregnancy rates over an observational period of 16 months. Forty-nine consecutive women were seen.

Disposable devices for measuring intraocular pressure: a clinical study to assess their accuracy.

Aims: We conducted a study to compare the accuracy of two commercially available disposable tonometry devices (the acrylic biprism, Tonosafe and the silicone shield, Tonoshield) with the standard Goldmann applanation tonometer (GAT).

Methods: A total of 80 eyes of 40 patients were randomly assigned to two groups. Group A (40 eyes) had the intraocular pressure IOP measured using GAT and the acrylic biprism (Tonosafe), while Group B (40 eyes) had IOP measured using GAT and the disposable silicone shield (Tonoshield).

Prediction of cosmetic outcome following conservative breast surgery using breast volume measurements.

This study was undertaken to examine the feasibility of breast volume estimation as a predictor of cosmetic outcome. We looked at the cosmetic result of conservative surgery related to the percentage of breast tissue removed. The breast tissue excised was calculated by comparing the breast volume, calculated from the mammogram, and the specimen volume.

Breast volume assessment: comparing five different techniques.

Breast volume assessment is not routinely performed pre-operatively because as yet there is no accepted technique. There have been a variety of methods published, but this is the first study to compare these techniques. We compared volume measurements obtained from mammograms (previously compared to mastectomy specimens) with estimates of volume obtained from four other techniques: thermoplastic moulding, magnetic resonance imaging, Archimedes principle and anatomical measurements.

A rare complication of a prostatic stent.

We describe a case in which an elderly man with deteriorating lower urinary tract symptoms had problems with an indwelling prostatic stent. We discuss the merits of prostatic stents and recommend indications for their use.

Prevalence of hepatitis B virus markers in surgeons in Lagos, Nigeria.

Objective: To determine the prevalence of hepatitis B virus (HBV) markers in surgeons in a major city in Nigeria.

Design: A cross-sectional, descriptive study.

Setting: Three major hospitals in Lagos, Nigeria.

Hysteroscopic sterilization using a micro-insert device: results of a multicentre Phase II study.

Background: Unlike laparoscopic surgery for interval tubal sterilization, a hysteroscopic approach obviates surgical incision and requires only local anaesthesia or intravenous sedation. The safety, tolerability and efficacy of an hysteroscopically placed micro-insert device was evaluated.

Methods: A cohort of 227 previously fertile women participated in this prospective international multicentre trial.

The outcome of drug smuggling by 'body packers'--the British experience.

Body packing or internal concealment used by drug dealers to smuggle illicit substances, puts the body packer at risk of both imprisonment and death. We report our experience over a 4 year period from January 1996 to December 1999 of suspects presenting to our hospital (the largest series in Europe). A total of 572 cases were assessed radiographically and 180 were shown to be carrying foreign bodies.

The safety and effectiveness of a new hysteroscopic method for permanent birth control: results of the first Essure pbc clinical study.

Background: Current methods of female surgical sterilisation require incisional surgery, general anaesthesia and a prolonged recovery time. We studied the safety and effectiveness of Essure pbc, a minimally invasive, transcervically placed micro-insert that occludes the Fallopian tubes, resulting in permanent female contraception. Device under study: The Essure pbc implant is a dynamically expanding micro-insert which is placed in the proximal section of the Fallopian tube using a modified minimal access technology for cannulating the tube.

The peri-areolar incision--gateway to the breast!

Background: In breast surgery the challenge for good cosmesis needs to be met in the management of benign or malignant disease. With tumours this must be balanced against good clearance with safe and adequate margins. For excision of benign lesions obvious deforming scars are unacceptable while with breast preserving cancer surgery a badly placed scar reduces reconstructive choices.

Breast mass removal made easy by the lump extractor: introducing a new instrument in breast surgery.

The difficulty encountered in the removal of breast lumps has been addressed by the use of a new instrument. The lump extractor described in this paper allows minimal scar surgery and prevents crushing of the breast mass.

Near-fatal gamma-butyrolactone intoxication--first report in the UK.

Gamma-hydroxybutyrate (GHB) is a compound used in the treatment of alcohol withdrawal, narcolepsy, and for induction of anaesthesia. It is also contained in many products illegally marketed as "dietary supplements" and is increasingly being recognised as a potential drug of abuse. We report the case of a 44-year-old man who suffered coma and life-threatening respiratory depression following an accidental overdose of the GHB prodrug, gamma-butyrolactone (GBL), contained in a "health drink".

Techniques for improving the cosmetic outcome of breast conservation surgery.

This paper presents techniques to enhance the aesthetic results of conservative breast surgery. A number of methods are described to improve results of conservative surgery by limiting deformity, reducing scars and by immediate replacement of tissue. By application of the appropriate technique breast tumours may be excised from any quadrant in a large or small breast with a good cosmetic outcome.