The effects of preservation on microvascular vein grafts in rats

Segments 15 mm in length were excised from the femoral veins of rats and preserved by refrigeration at 4 C in lactated Ringer's solution for periods up to 21 days. The findings show that veins can be preserved for up to seven days and successfully grafted to recipients. Although there was some success in preserving vein segments for more than seven days, a high rate of thrombosis occurred after implantation in the recipients. It is generally accepted that damaged endothelium causes thrombosis. The light and electron microscopic observations in this study, however, suggest that the condition of the endothelium may not be the only important factor in the patency of small vessels. A thickened and prominent elastic lamina may also play a role in keeping the lumen open.     

Demonstration of human papillomavirus types 6 and 11 in juvenile laryngeal papillomatosis by in-situ DNA hybridization

A study is reported in which an in situ hybridization technique for the demonstration of human papillomavirus (HPV) employing a biotin--streptavidin polyalkaline phosphatase complex has been successfully applied to formalin-fixed paraffin-processed tissue obtained from ten patients with juvenile laryngeal papillomatosis. In all cases, positive results were obtained for either HPV type 6 or 11. Normal vocal cord epithelium was negative.     

A technique for the placement of a long-term hyperalimentation catheter in the head and neck oncology patient

The relative safety of silicone rubber catheters allows use of the deep brachial vein for long-term central venous access when other vascular access sites are unavailable or undesirable. After local infiltration, a small incision is made across the medial edge of the brachial biceps and the vein is isolated from the artery and median nerve. An introducer is used to aid in insertion of the catheter. Catheter position is checked with a postoperative radiograph of the chest. Sixty of our patients have had catheters in place from 14 to 200 days, with few complications. There was one catheter-related death from acute bacterial endocarditis and one case of clinical thrombosis. The surgical approach to the deep brachial vein provides a simple and safe method of long-term central venous access in the head and neck oncology patient, whereas regional therapy and treatment planning often preclude use of other more conventional access sites.     

2例丙肝患者伴发获得性大疱性表皮松解症

作者报道2例确诊的慢性丙肝病毒感染患者合并获得性大疱性表皮松解症（EBA）。两例患者临床上均表现为典型EBA，包括皮肤脆性增加及自发和继发于外伤后发生皮肤水疱，继而以粟丘疹和瘢痕愈合。EBA常常是一种免疫状态改变或低下的疾病。还需进一步研究在这两例患者中和一般情况下丙肝病毒是否诱发EBA。     

Nontuberculous mycobacterial disease and Aspergillus-related lung disease in bronchiectasis.

The aim of the present study was to determine whether patients with bronchiectasis and nontuberculous mycobacteria (NTM) have a higher prevalence of Aspergillus-related lung disease. A series of 30 consecutive patients with bronchiectasis and NTM (cases) were compared with 61 patients with bronchiectasis and no evidence of NTM (controls). Aspergillus serology and computerised tomography of the thorax were used to identify Aspergillus-related lung diseases, including aspergilloma, allergic bronchopulmonary aspergillosis and chronic necrotising pulmonary aspergillosis. The rate of positive Aspergillus serology was higher in cases with NTM disease compared with controls (10 out of 30 versus six out of 61). The radiological features of Aspergillus-related lung disease were also more common among patients with NTM disease than controls (six out of 30 versus none out of 61). This association between NTM disease and Aspergillus-related lung disease remained significant after adjustment for confounding effects of age and lung function (adjusted odds ratio 5.1, 95% confidence interval 1.5-17.0). Patients with bronchiectasis and nontuberculous mycobacterial disease have a higher prevalence of coexisting Aspergillus-related lung disease than patients with bronchiectasis and without nontuberculous mycobacteria. Identification of Aspergillus-related lung disease is important as prognosis amongst undetected cases is invariably poor.     

Comparison of morning versus afternoon cecal intubation rates

Background  

Many factors impacting cecal intubation rates have been examined in detail; however, little information exists regarding the effect of the timing of the procedure. We sought to examine any difference in cecal intubation rates between morning and afternoon colonoscopies and identify factors contributing to a discrepancy.