Laparoscopic appendectomy: a review of 95 consecutive suspected cases of appendicitis.

Objective: To assess the feasibility and efficacy of laparoscopic appendectomy.

Design: A review of a case series.

Setting: A single teaching and referral centre in Vancouver.

Multifocal uptake of Tc-99m mebrofenin in dilated liver ductules in a patient with cystic fibrosis.

A patient with cystic fibrosis and a previous cholecystectomy, underwent Tc-99m mebrofenin scintigraphy to rule out hepatobiliary disease. The scan revealed multiple focal collections of radiopharmaceutical within the liver parenchyma. This unusual pattern of multiple focal parenchymal activity may be specific for patients with cystic fibrosis.

Histologically proven pressure sore-related osteomyelitis in the setting of negative technetium bone scans. Case report.

Pressure sores are common in patients with spinal cord injury, stroke or debilitating medical illness. Contiguous osteomyelitis is a well recognized complication of pressure ulcers, but remains a challenging diagnostic and management problem. Technetium bone scan is purported to be an extremely sensitive, although nonspecific diagnostic test for osteomyelitis.

Clinical variability within Brachmann-de Lange syndrome: a proposed classification system.

Seven patients, including two sibs, with the Brachmann-de Lange syndrome (BDLS) are presented as representative of the different types of BDLS in a proposed classification system. Type I ("classic") patients have the characteristic facial and skeletal changes of BDLS using the criteria in the diagnostic index of Preus and Rex. Type I is distinguished from the other subtypes by prenatal growth deficiency (< 2.

Polyvinylchloride containers do not influence the hemodynamic response to intravenous nitroglycerin.

In-vitro evidence of sorption of nitroglycerin (NTG) to polyvinylchloride (PVC) containers suggests that these containers may deliver less nitroglycerin to the patient than glass containers. Sorption of NTG to the PVC container may result in hemodynamic changes in the patient when a fresh solution of NTG is prepared and administered from a PVC container. This study was designed as a prospective, randomized trial to measure the hemodynamic response in patients receiving NTG in glass or PVC containers, during the first hour after a container exchange.

Laparoscopic gastrointestinal anastomoses.

In a preliminary study of laparoscopic gastrointestinal anastomosis, a gastric outlet obstruction was created under laparoscopic control in six domestic pigs, weighing an average of 25 kg. A simultaneous gastroenterostomy was formed with an end-stapling device. All animals recovered clinically, and good anastomotic healing was documented 1 week postoperatively.

Fracture of the laryngeal cartilage. An incidental finding on bone scintigraphy.

A patient complaining of headaches and bone pain at multiple sites had Tc-99m MDP scintigraphy performed for possible bone trauma after a motor vehicle accident. Bone imaging revealed a small focal increase in tracer uptake in the area of the laryngeal cartilage. There was some reluctance to place a label on this abnormality because the findings were so unusual.

Bacteremic pneumonia caused by penicillin-resistant pneumococci: Case report and review with a Canadian perspective.

A Canadian adult with bacteremic pneumonia caused by a relatively penicillin-resistant (minimal inhibitory concentration 0.25 μg/mL) Streptococcus pneumoniae is reported, and the published literature regarding penicillin-resistant pneumococci in Canada reviewed. Although penicillin resistance has been reported infrequently to date, this case emphasizes the need for routine antimicrobial sensitivity testing of all pneumococci isolated from normally sterile sites, and for ongoing systematic surveillance for penicillin and other antibiotic resistance in Canada.

Craniosynostosis associated with partial duplication of 15q and deletion of 2q.

We report on an infant with multiple congenital anomalies including complex craniosynostosis associated with an unbalanced karyotype, 46,XY,-2,+der(2),t(2;15)(q37;q26)pat. The previous report of a child with cloverleaf skull and partial duplication of 15q25----qter and the Man-on-Mouse Homology map suggests that a critical segment for synostosis of sutures may be in this region.

The effect of intraovarian injection of oxytocin and vasopressin on ovulatory function and numbers of ovarian follicles.

Our findings support the clinical use of vasoconstrictor solution within the ovary to achieve hemostasis. This will allow the gynecologist to avoid the thermocoagulative injury to the ovary by replacing electrosurgery and laser surgery with sharp incision accompanied by vasoconstrictor injection.

The combined use of vibrostimulation and in vitro fertilization: successful pregnancy outcome from a retrograde specimen obtained from a spinal cord-injured male.

While pregnancies have been documented through the independent use of the vibrator method, from other methods of procuring ejaculate from spinal cord injured men, and from artificial insemination using a retrograde specimen, we believe that this is the first case report of a live birth resulting from a retrograde ejaculate obtained by vibration from a spinal cord-injured male whose partner underwent in vitro fertilization. Vibrostimulation may well be successful in the two-thirds of men whose spinal cord lesions are at the T10 neurological level and above, who have an intact bulbocavernosus reflex and anal tone but no pain or temperature sensation of the genitalia. Blood pressure monitoring, prevention of autonomic dysreflexia, alkalinization, dilution and infection control of urine, and retrograde specimen retrieval are all important techniques to ensure patient safety and optimal ejaculates.

Allergic and inflammatory aspects of chronic rhinosinusitis.

The pathophysiology of rhinosinusitis is complex and poorly understood. Although it is recognized that obstruction of the sinus ostia which is surgically correctable contributes to recurrent bacterial sinusitis, allergic and nonallergic inflammation may contribute to or mimic infectious rhinosinusitis. Those aspects of rhinosinusitis which are not necessarily surgically correctable require consideration and may affect surgical prognosis.

Laparoscopic appendectomy.

In October 1989 the author began a study of laparoscopic appendectomy. This paper presents the preliminary results in 21 patients. Laparoscopy was carried out for diagnosis and 12 patients underwent laparoscopic appendectomy.

Tricyclic drugs in pregnancy and lactation: a preliminary report.

The management of severe depression during pregnancy and lactation is a serious concern to both physicians and parents, since the use of tricyclic antidepressant drugs (TCAs) has not been proven to be safe. This is a preliminary report of our ongoing studies of four groups of women treated with tricyclic antidepressants before and during pregnancy and/or lactation. The four groups are women who: became pregnant while on TCAs (n = 9); were prescribed TCAs during pregnancy (n = 9); were prescribed TCAs during lactation (n = 20); or were clinically depressed during lactation, but who refused TCAs (n = 5).

Neuroblastoma in a child with Wiedemann-Beckwith syndrome.

We report on a patient with Wiedemann-Beckwith syndrome (WBS) who developed abdominal neuroblastoma. Although WBS patients are known to have a higher incidence of embryonal tumors, this is only the 4th known case of neuroblastoma associated with this syndrome. Chromosomes on peripheral lymphocytes and tumor cells were normal.

Hypomelanosis of Ito--a nonspecific marker of somatic mosaicism: report of case with trisomy 18 mosaicism.

We report on a patient with hypomelanosis of Ito (HI), developmental delay, recurrent pneumonia, and facial asymmetry. Chromosome analysis done on blood and on one of three skin biopsies showed trisomy 18 mosaicism. This is the first report of HI associated with trisomy 18 mosaicism.

Urease-positive, Kanagawa-negative Vibrio parahaemolyticus from patients and the environment in the Pacific Northwest.

We previously reported the occurrence of Vibrio parahaemolyticus in patients and the environment in the Pacific Northwest. The present studies compare the biochemical characteristics, Kanagawa hemolysin reactions, and plasmid profiles of 13 patient and 221 environmental isolates of the organism. Classical biochemical testing of the isolates revealed similar reactions for the clinical and environmental strains, and analysis in agarose gels revealed that 13 to 15% of the isolates had plasmids.

Touch: a nursing strategy in the intensive care unit.

In this article findings are reported from a qualitative study that examined touch from the perspective of intensive care (ICU) nurses. In-depth interviews with eight experienced ICU nurses and participant observation were used to collect data. Three distinct kinds of touch were identified, as well as normative patterns of touch among ICU nurses.

Men sexually assaulted as adults and sexually abused as boys.

Previous research on sexually victimized men has mainly addressed the acute symptoms seen in hospital emergency rooms and psychiatric clinics. Findings are reported on 14 men, all but 1 of whom had been sexually traumatized much earlier in life, as boys or young adults. Several problem areas are described: repression, denial, or normalization of the trauma; self-blame and shame; posttraumatic stress disorder; male gender identity fragility; sexual orientation ambiguity and internalized homophobia; sexual difficulties; mistrustfulness of adult men; and disturbances of self-esteem and body image.