Small bowel obstruction at a Filshie clip applicator port site

Laparoscopic Filshie clip sterilisation remains a common method of permanent female contraception. Worldwide, approximately 190 million couples use tubal occlusion (United Nations world population monitoring. United Nations, 2002). Trocar site incisional hernia has been reported as a complication of laparoscopic surgery where a 10-mm port was employed (Tonouchi et al. Arch Surg 139(11):1248–1256, 2004). It is common practice to repair port sites of 10 mm or more to prevent herniation. Port sites of 5 mm are not routinely repaired by most surgeons because it is thought that such iatrogenic fascial defects are not large enough to predispose to hernia (Reardon et al. J Laparoendosc Adv Surg Tech A 9(6):523–525, 1999). We report a rare case of early Filshie clip applicator port site intestinal obstruction following laparoscopic sterilisation. The mechanism of hernia formation and a preventive strategy are discussed.     

Rheologic investigation of electrode gels

Nine electrode gels have been investigated 6 of them are used in hospital pharmacies of this country. The results were compared to properties of two gels from abroad, the recommended electrode gel has been developed on this basis. Character of formed gel structure has been studied by flow curves and structural forces have been numerically characterized by determining the parameters of the function made linear. By determination of electric conductivity the proposed Carbopol gel has been found suitable not only to supersonic tests but also to ECG and may be to EEG.     

Geographic areas with extremely high mortality correlations for cancers in the province of Alberta, Canada

Age-adjusted mortality rates, calculated by the direct method and based on the 1971 census-population of Alberta, for 24 male and 26 female cancer sites, from 29 census sub-divisions of the province of Alberta, collected over the period 1961 through 1981, were employed in this study. A total of 50,374 cases of cancer mortality were utilized. Correlations between pairs of cancer sites across census sub-divisions were calculated and cancer sites noted that varied little in mortality rates over Alberta's geographic areas. Significant correlations of mortalities (p less than 0.01) were observed between 5 pairs of male cancer and 18 pairs of female cancer sites. Risk factors common to correlating pairs are discussed. Similarities of our results with other studies are pointed out. The geographical distribution of extreme mortality correlations is analyzed and possible risk factors are discussed.     

Factors influencing the survival of patients with cancer of the stomach

During the period 1969 through 1973, 332 male and 135 female patients diagnosed with stomach cancer were registered with the Cross Cancer Institute in Edmonton, Alberta. These patients were followed up to December 31, 1981. Therefore, we were able to observe eight year survival times for all patients. Rates for one to eight years of survival were calculated using the Kaplan-Meier method. The results showed poor survival experience for male and female patients, similar to survival reported in other countries. Stomach cancer in Alberta belongs to the ten most common cancers and a search for factors influencing survival is therefore important. A large number of environmental factors and factors pertaining to the patients' lifestyle, as well as clinical factors related to stage of disease and treatment were examined using Cox's proportional hazard model. Surgical treatment and the presence of metastases were found to be important determinants of survival for both sexes. In males, increased age and British ethnicity were associated with poor survival prospects. Relative hazards of dying are presented for various combinations of factors.     

External iliac artery endofibrosis in an amateur runner: hemodynamic, angiographic, histopathological evaluation and percutaneous revascularization

We describe a case of external iliac artery endofibrosis in an amateur competitive runner. The diagnosis was made by a combination of hemodynamic, angiographic and histopathological assessment and percutaneous revascularization was performed using a balloon expandable stent.     

Expressions of Topoisomerase IIα and BCRP in Metastatic Cells are Associated with Overall Survival in Small Cell Lung Cancer Patients

The aim of this study was to investigate the mRNA expression levels of multidrug resistance-associated proteins in chemo-na?ve metastatic lung cancer cells and to determine the correlation with response to chemotherapy and overall survival. Metastatic cells were obtained by transbronchial fine needle aspiration biopsy of enlarged mediastinal lymph nodes in 14 patients with small cell lung cancer (SCLC) and 7 patients with non-small cell lung cancer (NSCLC). After cytological confirmation of lung cancer type, total RNA was extracted from biopsy samples and reverse transcribed to cDNA, and real-time PCR for the genes of interest [P-glycoprotein (P-gp), multidrug resistance protein 1 (MRP1), breast cancer resistance protein (BCRP), lung resistance protein (LRP) and topoisomerase IIα (TOPIIα)], was performed. We observed significantly decreased expression of BCRP and significantly increased expression of TOPIIα in metastatic SCLC cells compared to NSCLC. Furthermore, in SCLC high topoisomerase IIα and low BCRP expression levels positively correlated with longer overall survival. Our results showed higher expression levels of BCRP as well as lower levels of topoisomerase IIα in chemo-na?ve metastatic cells in NSCLC than in SCLC. These results correlate with previous observations that metastatic SCLC cells at the beginning of chemotherapy are potentially more sensitive to chemotherapeutic agents while in metastatic NSCLC cells resistance is usually inherent. We also showed that altered levels of topoisomerase IIα and BCRP in SCLC are important factors that contribute to resistance to chemotherapeutics that interfere with the enzyme and/or DNA and are highly associated with overall survival.