The effect of soy isoflavones on the development of intestinal neoplasia in Apc mouse

Data from epidemiological studies suggest that isoflavones in soy may have a protective effect on the development of colon cancer in humans. Therefore, we have investigated whether soy isoflavones will inhibit intestinal tumour development in Apc^Min mice. The mice were fed a Western-type high risk diet (high fat, low fibre and calcium) containing two different isolates of soy protein as a protein source. For the control and test groups this resulted in the administration of about 16 and 475 mg of total isoflavones per kg diet, respectively. As a positive control, a third group of mice was administered a low isoflavone diet supplemented with 300 ppm sulindac. No significant differences in the incidence, multiplicity, size and distribution of intestinal tumours were observed between Min mice fed low and high isoflavone-containing diets. However, a clear reduction in the number of small intestinal tumours was observed for the sulindac diet. Thus, in contrast to epidemiological studies, our results demonstrate that high amounts of soy isoflavones present in a Western-type high risk diet do not protect against intestinal tumour development in a relevant animal model such as the Min mice.     

Reconstructive rectal surgery.

Rectal cancer causes approximately 6000 deaths in the UK each year. The role of the surgeon in rectal cancer is to control local disease and minimise the risk of recurrence. Reconstructive rectal surgery for cancer aims to combine a safe oncological procedure with the maximum quality of life possible. An improved understanding of rectal cancer pathology allied to modern surgical techniques such as intestinal stapling guns, endoanal anastomoses and the colonic pouch has led to an increased number of sphincter saving operations being performed. We have reviewed the background, technical advances and looked at the future of reconstructive rectal surgery for rectal cancer. Firstly we discuss the work which led to low anterior resection being accepted as an oncologically safe operation. followed by an overview of surgical techniques that have facilitated low anterior resection for rectal cancer with good functional results for the patient. Lastly, we look at the role of radiotherapy and the neosphincter in reducing the need for a permanent stoma.     

Resistive index: an experimental study of the normal range in the pig

OBJECTIVES: To study the normal range and distribution of the resistive index (RI) and the resistive index ratio (RIR) in the non-obstructed non-dilated porcine kidney, and to assess the reliability of the threshold values RI 0.70 and RIR 1.10 as prognosticators of true obstruction in the upper urinary tracts. METHODS AND MATERIALS: Twenty female pigs of Danish land race breed were studied under general anaesthesia. Blood pressure and urine output was monitored throughout the experiment. Doppler evaluations were obtained from an interlobar artery in the lower half of each kidney, and the RI was calculated as the average of 3 x 3 cycles for each side independently. Statistical analysis of the obtained results was performed. RESULTS: Forty renal units were studied. The RI values ranged from 0.48-0.85 (mean 0.63). Nine renal units (22.5%) had RI values > or = 0.70. RIR values ranged from 1.00-1.38 (mean 1.07). Three RIR values (15%) were above 1.10. There was no statistically significant relationship between RI and laterality (p = 0.25), and no overall significant relationship between RI and mean arterial blood pressure (r2 = 0.21) or urine output (r2 = 0.004). CONCLUSIONS: This study shows a wide distribution of the RI normal values in the pig model, and our results do not support the normal ranges for RI and RIR, or the cut-off values used in clinical practice.     

Children's health care: Book and media reviews

Let's Remember Corky, Fine, Polly Delson, Shaker Heights, Ohio, 1981. Paperback, unpaged, $4.75.

The Tenth Good Thing about Barney, Viorst, Judith, Hartford, Atheneum, 1971. Paperback, 20 pages, illustrated by Erik Blegvad.

Jasper Enters the Hospital, 16½ mins., The Day of Jasper's Operation, 13½ mins., Wellness: It's Not Magic, 15 mins., Video Cassettes‐ 16 mm. Available from: Kids Corner, 2027 North Tejon Street, Colorado Springs, Colorado 80907, (303) 475–2499.

First Do No Harm, produced by Pierce Atkins Corporation, 45 mins., S400 (purchase), S45 (daily rental). Distributed by Children's Hospital National Medical Center, 111 Michigan Avenue, N.W., Washington, D.C. 20010.

Pediatric Diagnostic Procedures With Guidelines for Preparing Children for Clinical Tests, Droske, Susan C. and Francis, Sally A. Toronto, John Wiley and Sons Inc., 1981.

The Children's Medical Series ‐ a series of eight videotapes with Susan Linn and her puppets.     

The incidence and morphological features of pyramidal lobe on thyroid ultrasound

The aim of this article is to document the incidence and appearances of the pyramidal lobe of the thyroid gland, and discuss the clinical relevance of this entity in sonographic practice. A prospective study was undertaken over a period of 10 months. A total of 416 consecutive patients attending head and neck ultrasound lists were scanned by a single experienced radiologist or an advanced practitioner sonographer. At the time of reporting, the presence of a pyramidal lobe was recorded. The anatomical morphology was classified into five subgroups devised for the purposes of the study. Appearances were documented in both normal and pathological glands. Of the total number of patients scanned, 90 patients were found to have pyramidal lobes, giving an overall incidence of 21%. In all, 51% were found to originate from the right of the isthmus, 46% from the left and 2% from the midline. One patient had two pyramidal lobes. A significant number of patients having routine neck ultrasounds have an incidental finding of a pyramidal lobe. Ultrasound is an effective modality for the demonstration and classification of the pyramidal lobe, as well as identification of pathology. It is important for radiologists to be aware of this normal variation, as it may be the site of primary or recurrent thyroid pathology. Radiologists should report it where relevant to ensure adequate surgical treatment of pathological glands.