Use of fibrin glue in obstetrics and gynecology: a review of the literature.

Most authors consider the principal advantage of FG anastomoses (compared to microsurgical anastomoses) to be shorter operating time, reduced surgical trauma to oviduct stumps, and absence of tissue ischemia. These features promote reparative regeneration and decrease adhesion formation, resulting in complete recanalization of fallopian tubes. To date, the majority of work on FG is confined to the experimental development of surgical techniques. Investigations in reconstructive gynecological surgery are quite uncommon. The physical properties of FG and the positive results of available experimental studies suggest that further development of surgical techniques using FG in obstetrics and gynecology is worthwhile.     

Sustained eosinophil cationic protein release into tears after a single high-dose conjunctival allergen challenge

Background The appearance of eosinophils is a hallmark sign of the allergic late-phase response (LPR). Eosinophil cationic protein (ECP), a readily measurable product released from activated eosinophils, has so far not been evaluated in the ocular LPR. Objective Two sets of trials were performed in order to investigate changes of local and systemic eosinophil activity and their possible link with symptoms and hyper-reactivity in the allergic LPR in the eye. Methods In the first experiment, ECP was analysed in tears and serum and the clinical reaction was evaluated during a 72-h time–course after a single, high-dose allergen challenge out of season in one eye of 15 pollen-sensitized volunteers. In a second experiment, the hypothesis of an increased clinical response to an allergen challenge in an eye that had been provoked with allergen 48h previously was tested in nine sensitized individuals. Results In the first experiment, symptoms at 10 min and 2, 4, 6, 8 and 24 h significantly exceeded base line scores of the challenged eyes. Tear ECP was significantly elevated in challenged eyes compared to contralateral eyes at 6, 8 and 24 h. In addition, symptoms and ECP release correlated significantly at the 24-h evaluation. Serum ECP remained unchanged throughout the study period. In the second experiment, conjunctival hyperreactivity 48h after an allergen challenge was not confirmed. Conclusion ECP secretion occurs in the experimental ocular LPR and is in part associated with the magnitude of the clinical reaction, which suggests a truly pathogenic role of the activated eosinophil in pollen-induced allergic conjunctivitis.     

Sodium sensitivity: a determinant of essential hypertension

The epidemiologic correlation of chronic dietary salt intake among populations with the prevalence of hypertension has resulted in the concept that sodium plays an etiologic role in the development of essential hypertension (EH). However, the association of sodium intake with blood pressure in individuals within populations has been difficult to demonstrate. The differing human responses to sodium intake are dependent upon the individual level of sodium sensitivity or sodium resistance. Factors associated with sodium sensitivity are race, age, and other dietary factors. More recent investigations have pursued the interaction of sodium intake with other physiologic parameters including neurogenic activity, vascular structure, renal function, and other cations such as potassium and calcium. The observations that some humans demonstrate very little increase in blood pressure despite high levels of sodium intake supports the concept that a high sodium intake alone is not a single causal factor in hypertension. Sodium intake appears to interact with renal excretory capacity and vascular compliance. These varying physiologic functions must be delineated to characterize sodium sensitivity.     

Ankle injuries and the family physician

In transmitting the body's weight, the ankle is subject to frequent static and dynamic injury due to concentrated stresses during standing and movement. The frequency of athletic ankle injuries ranges from 10 to 90 percent, with the highest rate occurring in basketball players. There is prolonged disability and recurrent instability for months to years for 25 to 40 per cent of these patients. Because most of this trauma is handled by primary care physicians, this review presents the mechanism of injury, relevant anatomy, physical examination, and appropriate therapeutic intervention in the acute and rehabilitative phases.     

Chorioretinal folds and a macular hole secondary to craniofacial surgery

Chorioretinal folds have been reported as a result of many intraocular and extraocular inflammatory processes or tumors. Visual loss is usually secondary to a combination of the underlying process and chorioretinal folds involving the macula. We report a patient who developed decreased vision, metamorphopsia, chorioretinal folds, and a lamellar macular hole secondary to global compression by a bone fragment. The chorioretinal folds regressed and his vision stabilized following surgical decompression. Chorioretinal folds and lamellar macular hold formation are previously unrecognized complications of reconstructive craniofacial surgery.     

Accessory left-ventricular chorda and the early ventricular repolarization syndrome

Electrocardiographic symptoms were evaluated in 53 patients with an additional left-ventricular chorda (ALVC), detected by two-dimensional echocardiography. Signs of early ventricular repolarization (EVR) were identified in 45 (84.9%) patients. A transverse ALVC was more common in EVR-free patients (87.5%), as compared to patients with ALVC + EVR combinations (51.1%; p less than 0.05).