Diagnosis and management of endometriosis of the colon and rectum

Colon and rectal endometriosis is a relatively rare entity that may have a wide array of clinical symptomatology and radiographic findings. Thirty-two patients with a diagnosis of colon or rectal endometriosis were seen and treated at the Ferguson Clinic between 1960 and 1986. Diagnostic, pathologic, and therapeutic findings were reviewed. All patients, except one, had large-bowel symptoms. Ten patients had previous histories of pelvic endometriosis. When endometriosis of the colon causes significant symptoms or a neoplasm cannot be ruled out, partial colectomy is recommended. If pelvic endometriosis is extensive, removal of the endometriomas and reproductive organs should be entertained concurrent with bowel resection. Hormonal manipulation may be attempted in certain select patients, with very close follow-up.

Effect of pulmonary vascular pressure on lung lymph flow following seizures

The effect of elevated baseline pulmonary vascular pressures on systemic and pulmonary vascular sequelae of prolonged seizures was studied in sheep. Five animals with seizures induced after baseline left atrial pressure elevations of 25 mm Hg were compared with animals treated with seizures alone. Seizure-induced elevations from baseline of systemic and pulmonary vascular pressures were identical in the two groups both in height and duration. In animals with left atrial balloon inflation prior to seizures, however, the peak pulmonary arterial and left atrial pressures were the sum of baseline elevation (induced by left atrial balloon inflation) and the seizure-induced pressure elevation. Accordingly, the resultant pulmonary vascular pressure and resultant pulmonary lymph flow elevations, were substantially greater in these animals with elevation in baseline pulmonary vascular pressures. Therefore, patients with pulmonary vascular hypertension are at greater risk for pulmonary edema during seizures.

Pulse oximetry for vascular monitoring in upper extremity replantation surgery

Pulse oximetry as a postoperative monitor for replanted or revascularized digits was evaluated experimentally and clinically. The accuracy of detection of vascular occlusion was 100%, and arterial and venous occlusion could be differentiated by changes in pulse inflow and oxygen saturation. Digits demonstrating O2 saturations above 95% remained viable, those below 85% were associated with venous occlusions, and those with no saturation represented arterial occlusions. This method is simple, noninvasive, continuous, and accurate, and it reliably assesses revascularized digits and replanted parts.

Measurement of blood flow in hypospadias flaps with subvisual doses of fluorescein

Hypospadias flap viability is determined most often by direct observation or injection of visual doses of fluorescein and observation with a Woods lamp. We support the use of a dermofluorometer and subvisual doses of fluorescein to measure tissue fluorescence in predicting flap viability.

Questionnaire survey of pruritus and rash in grain elevator workers

51.4% of 1,954 grain elevator workers surveyed in 1978 and 1979 complained of pruritus following exposure to grain dusts. 95% of 796 grain elevator workers surveyed in 1985 noted that pruritus following exposure to grain dust was of short duration. Exposure to barley dust and oat dust provoked the greatest number of complaints. Those with a past history of infantile eczema were significantly more likely to complain. Younger workers were more likely to complain than older workers. 13.1% of those surveyed in 1985 complained of a rash following exposure, in 35% of whom it lasted more than 1 day. Nasal congestion, ocular and oropharyngeal irritation were also frequent complaints.

Bromocriptine in the treatment of hypertension

The efficacy of bromocriptine in the treatment of hypertension was assessed in a double-blind placebo controlled cross-over study preceded by a dose titration phase. A diuretic and/or a beta-blocker were administered concomitantly in constant dosage to 11 of the 20 patients who received bromocriptine. A wide range of doses of bromocriptine was tolerated. Side-effects of vomiting and postural hypertension did not occur, possibly due to the gradual increase in the administered doses. Plasma prolactin was not raised in this population of hypertensives. In the dose titration phase (n = 20), a small fall in diastolic but not in systolic blood pressure occurred with bromocriptine, but only with the patient standing and after exercise. In the double-blind phase (n = 9), there was no significant difference in blood pressure between the bromocriptine and placebo treatments. It is concluded that bromocriptine was not effective in lowering blood pressure in the present patients with essential hypertension.

Does plasma transferrin regulate iron absorption?

It has been suggested that transferrin that has recently donated its iron to receptor sites is 'activated' to take up iron more avidly from donor tissues. The hypothesis was tested in vitro in a system in which use was made of the different electrophoretic mobilities of normal and desialated transferrin. Recently desaturated transferrin and native apotransferrin were added in equal amounts to a solution of radioactive ferric citrate to produce various end saturations. The resultant mixture was electrophoresed on 5.4% polyacrilamide gel, which was then sliced and counted for 59Fe counts. The size of the 2 radioactive peaks was then compared and expressed as a ratio. Using this in vitro system no supporting evidence could be found for the hypothesis that diferric transferrin which has just donated its iron is able to bind available iron more avidly than native apotransferrin.

Anterior compartment syndrome in a patient with fracture of the tibial plateau treated by continuous passive motion and anticoagulants. Report of a case

Open reduction and internal fixation with anterior compartment fasciotomy for fractures of both tibial plateaus in a 36-year-old woman was complicated by deep-vein thrombosis three days after surgery. After establishing anticoagulation, continuous passive motion (CPM) was instituted. Twenty-four hours after the commencement of CPM, an anterior compartment syndrome developed. A second operation revealed a large hematoma within the anterior compartment musculature, the development of which appeared to be the result of the combination of continuous passive motion and anticoagulation therapy in a seriously injured limb. In this clinical condition, especially close observation for the development of signs of elevated intracompartmental pressure is mandatory.

Iron absorption from red and white wines

Iron (3 mg) was added as ferrous sulphate to 2 dl red wine, white wine and 7% alcohol and its absorption was then measured in 38 fasting male subjects. (The original concentrations of iron in the two wines were low, being 1.01-1.08 mg/l (red wine) and 0.13-0.20 (white wine]. The geometric mean absorption from red wine was only 20% of that from the alcohol solution whilst more than 4 times as much was absorbed from white wine as from the alcohol. Direct comparison showed greater absorption from white wine (10.4%) than from red wine (4.4%). Removal of about 80% of the polyphenols in red wine increased the geometric mean iron absorption from 1.9% to 3.6%. In vitro experiments indicated that iron was less soluble and less dialysable in red wines than in white wines. This was possibly due to the binding of iron to polyphenols in red wines. Electrophoretic studies suggested that the iron in white wines was complexed to hydroxycarboxylic acids.

Transformation of human embryo cells with the use of cell-free extracts of a human rhabdomyosarcoma cell line (HUS-2): brief communication

Cell-free extracts of the human rhabdomyosarcoma cell line HUS-2 caused the transformation of human embryo fibroblasts. This transformation included morphologic alteration, karyotypic change, and an increase in culture longevity. With the use of sex markers, multiple karyotypes confirmed that the human embryo fibroblasts were transformed, and the use of cell-free material further suggested the presence of a transforming virus. RNA-dependent DNA polymerase activity in a particle with a specific gravity of 1.16 g/cm3 indicated the presence of an RNA type C virus. Evidence also suggested that the known mammalian type C viruses, routine cytopathic effect-inducing viruses, or mycoplasma were not the agents responsible for the transformation. That both the donor (HUS-2) and converted (HUE-T) cell lines cross-reacted with antisera prepared against HUE-T indicated a common antigen arising in the process of conversion of HUS-2 cells to HUE-T cells.

Immunocompetent cells in man. IV. The inhibition of pokeweed mitogen-induced blastogenesis of normal human peripheral leukocytes by trypsin: a B-cell mitogen of mouse, but not of human, lymphocytes

Normal human peripheral blood lymphocytes were tested for their blastogenic response in vitro to trypsin. Although it has been shown by other investigators that mouse B lymphocytes are stimulated trypsin to undergo blastogenesis, we have shown that human lymphocytes are not stimulated by trypsin. Paradoxically, trypsin inhibits the response of human lymphocytes to pokeweed mitogen, a B-cell stimulat, without significantly affecting the response of these cells to phytohemagglutinin, a T-cell stimulant. These results serve to underline the functional dissimilarity of mouse spleen cells and human circulating lymphocytes, at least with respect to their blastogenic responses to mitogenic agents.