Somatostatinomas, PPomas, neurotensinomas

We have reviewed data pertinent to three tumor syndromes that derive from overproduction of three GEP peptide hormones. The clinical syndrome of somatostatin excess remains well defined with diabetes, diarrhea, steatorrhea being predominant features. With the availability of assays and increasing awareness, more cases are being diagnosed in the intestine and these differ somewhat in their presentation with cholecystitis, GI bleeding, or a mass as the cardinal features. An unusual association with MEN II pheochromacytoma and neurofibromatosis is emerging. PPomas remain enigmatic. Although diarrhea is a feature, these tumors are usually silent and present with hypatomegally, abdominal pain, and jaundice because of the large size and malignant nature. Neurotensinomas remain rare and truly difficult to separate from the symptom complex produced by VIP excess. Edema, hypotension, cyanosis and flushing should alert one to the possibility of a neurotensin-secreting tumor.     

A comparison of glycine, sarcosine, N,N-dimethylglycine, glycinebetaine and N-modified betaines as liposome cryoprotectants.

Glycinebetaine has previously been shown to be effective at reducing leakage from liposomes which are frozen then thawed. This study involved the preparation of a series of N-modified betaines and the comparison of their cryoprotective activities with those of glycine, sarcosine, N,N-dimethylglycine and glycinebetaine. All the compounds investigated, with the exception of (dimethyloctylammonio)acetate, reduced the degree of leakage, after freezing and thawing, with additive concentrations up to 0.6 M. Reducing the degree of N-terminal methylation of glycinebetaine appeared to increase the leakage from liposomes at additive concentrations between 0.2 and 0.6 M. (Dimethylethylammonio)acetate, (dimethylisopropylammonio)acetate and (N,N,N',N'-tetramethylethylenediammonio)-N,N'-diacetate appeared to be no more effective than glycinebetaine, whereas improved protection was afforded by (triethylammonio)acetate and (diethylmethylammonio)acetate at most concentrations. This study demonstrates that the cryoprotective activity of glycinebetaine may be improved with modifications to the N-terminal.     

From Kocher to Allgöwer: The International Society of Surgery/La Société Internationale de Chirurgie

Conclusion The saga of the Society—from Kocher to Allgöwer-rings with true accomplishment. As we near the end of our first complete century, we can look back with a sense of satisfaction. At the same time we must recognize that there still is much to do.I wish to paraphrase the words of Kocher's 1905 inaugural address:Presidential address to the opening of the Scientific Program of the International Society of Surgery/Société Internationale Chirurgie (ISS/SIC), August 23, 1993, Hong Kong.     

Haematology and biochemistry in healthy young pheasants and red-legged partridges and effects of spironucleosis on these parameters.

Plasma biochemical and haematological parameters were examined in 4-week-old to 12-week-old game birds. Healthy, uninfected pheasants and partridges had similar levels of total protein, albumin, osmolality, Na+, Cl-, K+, Mg2+ and glucose. Triglyceride, globulin and Ca2+ were significantly higher and PO43- was lower in the partridges. Pheasants carrying a light to moderate infection with Spironucleus had significantly lower total protein, albumin, osmolality, Na+, Cl-, Ca2+ and PO43-. In severely affected pheasants, the osmolality, Na+ and Cl- fell further. Triglyceride and glucose were significantly lower than in healthy birds, and Mg2+ was higher. Similar data were obtained from infected partridges. Red cell parameters rose significantly in pheasants severely affected by spironucleosis, and the percent of heterophils was significantly higher and lymphocytes and basophils lower in their blood smears. The breast and leg muscle wet weight from severely affected pheasants was 22.2 and 37.7% that of uninfected birds, although the water content of the breast muscle was significantly higher.     

A double-blind single dose comparison of intramuscular ketorolac tromethamine and pethidine in the treatment of renal colic

The efficacy of a single dose of intramuscular ketorolac 10 mg or 90 mg was compared with pethidine 100 mg in a randomized double-blind study in 121 patients reporting at least moderate pain due to renal colic. Pain was assessed before drug administration, and then at 1 hour and 12 hours after the dose. Sedation was also assessed at these times, and additionally at the 12 hour assessment the time of the next analgesic dose was recorded. At 1 hour after dosing, pain scores had decreased in all groups; the largest decrease was seen in the ketorolac 90 mg group. The difference in the decrease was significant between the two ketorolac groups, but the differences between ketorolac and pethidine were not significant. Fewer patients in the ketorolac 90 mg group (17%) required a further dose of analgesic within 10 hours than in either the ketorolac 10 mg group (39%) or the pethidine 100 mg group (47%). The difference between ketorolac 90 mg and pethidine 100 mg was statistically significant. At both assessment times the proportion of patients with no sedation was higher in the two ketorolac groups than in the pethidine group. The overall incidence of adverse events was low with all drugs, notably so for the occurrence of vomiting after ketorolac. The results of the study show that intramuscular ketorolac is efficacious in the treatment of renal colic.