Acute thrombosis of the non-aneurysmal abdominal aorta

Fourteen patients admitted over a 9 year period with acute thrombotic occlusion of the non-aneurysmal abdominal aorta have been reviewed. Twelve patients underwent aortic bifurcation graft reconstruction, one thromboendarterectomy alone, and one a re-entry operation for dissection. Two patients (14%) died in the perioperative period. The mean postoperative survival of the remaining patients is to date 55 (range 4-93) months with a mean follow-up period of 69 (range 18-100) months. The results indicate these patients should be treated aggressively by early reconstructive surgery in the expectation that the majority will survive their operation and gain a useful extension to their lives.

Open biliary surgery and the use of routine inpatient audit

'Morbidity profiles' offer a practicable and effective method of assessing overall surgical performance. In this study they have been used to document the results of elective and emergency open biliary surgery carried out on 246 consecutive patients over a 2-year period. The results demonstrate that such surgery for the treatment of cholelithiasis and its complications is extremely safe. There was one postoperative death (0.4%) and an in-hospital major morbidity rate of 4.6%. Minor morbidity was common, especially in the elderly and following emergency surgery. The data presented here will be of particular interest to the increasing number of surgeons advocating laparoscopic biliary surgery.

Cyclic adenosine 3',5'-monophosphate binding proteins in human colorectal cancer and mucosa

Cyclic AMP Binding Proteins (cAMP-BP) levels have been measured by means of a competitive binding assay in the cytosols of 50 human colorectal cancers. These levels have been related to those in mucosa both adjacent to and distant from the tumour in the same patients. Cyclic AMP-BP were higher in tumour than in either adjacent (P less than 0.000001) or distant mucosa (P less than 0.00001). Binding of cAMP in adjacent mucosa was lower than that in distant mucosa (P less than 0.0001). There was no significant difference in the level of binding between tumours arising from different sites in the colon and binding was not related to age or sex of the patient. However, binding was higher in Dukes' B than Dukes' C cancers (P less than 0.005). There was also a trend for cAMP binding levels to be higher in moderately differentiated than in poorly differentiated cancers (P = 0.07). Thus cAMP-BP appear to be over-expressed in human colorectal cancers and levels are related to the stage and grade.

The effect of seminal plasma on macrophage function--a possible contributory factor in sexually transmitted disease

The present studies confirm that small doses of human seminal plasma inhibit mitogen induced lymphocyte transformation and experiments in a murine model suggest this effect may be mediated through accessory macrophages. They also reveal that seminal plasma interferes with the attachment, spreading and phagocytic activity of C. parvum elicited murine peritoneal macrophages and the release of reactive oxygen species from zymosan triggered human peripheral blood monocytes and neutrophils. As macrophages are known to programme various aspects of the immune response our results may be relevant to the acquired immune deficiency syndrome (AIDS), the genesis of antisperm antibodies and the response to prostatic and cervical cancer.