Intraoperative radiotherapy of upper abdominal tumours

Thirty patients with malignant tumours in the upper abdomen underwent surgery and intraoperalive radiation (IORT), using electron beam, to: the surgical bed, residual or unresected tumour. The technical aspects and results of this treatment are described. Renal, adrenal, bile duct and gastrointestinal tumours were treated. along with several other lesions. The surgical procedure consisted in 10 cases simply of exposure of the tumour for IORT and in 20 the tumour was resected. The TORT dose ranged from 10 to: 20 Gv. In 13 patients, external beam radiation was also given to: residual tumour or to: areas of high risk for recurrence. Chemotherapy was given to: 10 patients. Tolerance to: the combined treatment was acceptable; with few complications related to: IORT.The median follow-up and survival time 23 months (range 4-more than 70 months). Local tumour control rate (or tumour stabilisation) is 90%. Distant metastases developed in 19 patients (63%). The actuarial survival rate for the group projected at 70 months (maximum follow-up) is 37%. IORT in useful in the management of tumours arising in the upper abdominal organs, for palliation surgery or when resectability of the tumour is in doubt. Indications for IORT include patients with uncommon tumours of the upper abdomen who are not be candidates for standardised cancer treatment.Presented at the European Congress of Radiology, Vienna, September 15–20,1991     

Coronary permeability and left ventricular function following thrombolytic therapy

We study 40 patients, 55 +/- 7 years old with acute myocardial infarction treated early by thrombolytic therapy (20 STK and 20 rt-PA). All patients were angiographically studied in the following conditions: 1) baseline, before initiating therapy. 2) Three hours after treatment. 3) Twenty four hours later. 4) Before discharge. The infarct related artery was patent 24 hours after treatment in 31 patients (78%); five of them were patent before treatment, and we observed an early reperfusion in 20 patients (57%) and late reperfusion in 6 patients (17%). The number of patients with angiographic evidence of intraluminal thrombus decreased progressively through conditions while the grade TIMI of coronary perfusion increased in the absence of reocclusion. Final regional wall motion of infarct related myocardial zones and their degree of recovery were significantly higher in recanalized patients, as compared with non-reperfused patients. Similarly, left ventricular functional recovery was higher in patients with antegrade of collateral flow to the infarct area, as compared with totally occluded patients.     

Pulmonary embolism.

Pulmonary embolism (PE) is an important health problem and often a major clinical challenge, not only because of the low specificity of its clinical manifestations but also because of the increasing number of medical circumstances that are risk factors for this illness and the importance of early identification, since prompt and appropriate treatment can decrease mortality from this disease by about 25%. In recent years research on PE has been extensive, directed mainly at trying to determine and characterize its risk factors, establish new clinical probability algorithms, develop new diagnostic methods and put existing ones into perspective, seek new therapeutic approaches (pharmacological and non-pharmacological), and above all establish protocols that can guide the clinician from the stage of clinical suspicion to measures to prevent recurrence. It was the authors' aim to review the most significant literature on this subject, in order to produce a text that reflects the state of the art concerning PE and that can be used as a guide in the clinical approach to this pathology.     

Cast syndrome

The term cast syndrome is used to denote duodenal obstruction occurring after application of a corrective plaster cast to patients with scoliosis. We report a classical case in a 14-year-old female who required surgical intervention after conservative treatment failed. Six months later the patient had no further gastrointestinal symptoms. Clinical, radiological, and pathological details as well as the surgical treatment are described and discussed. Offprint requests to: M. E. Martín Hortigüela     

Low plasma zinc and androgen in insulin-dependent diabetes mellitus

Plasma zinc and pituitary and testicular hormone concentrations were measured in two groups of male adolescents. One group comprised insulin-dependent diabetes mellitus patients, aged 14-19 years; the other, as control, included 12 healthy youngsters aged 13-19 years. Plasma concentration of zinc, prolactin, testosterone, and dihydrotestosterone were lower in diabetics than in controls, whereas the ratios of androstenedione and androstenedione to testosterone + dihydrotestosterone were higher. Plasma FSH and LH were normal. These results suggest a diminished conversion of androstenedione to testosterone and relate zinc with the 17-beta-hydroxysteroid dehydrogenase enzyme activity.     

Inhibitory effects of Santolina chamaecyparissus extracts against spasmogen agonists

Several extracts of Santolina chamaecyparissus ssp. squarrosa antagonized in a concentration-dependent way the contractions of rat duodenum, guinea-pig ileum, rat vas deferens and rat uterus as induced by acetylcholine, histamine, noradrenaline, oxytocin and serotonin. Polar extracts were less active than apolar extracts, and it was necessary to assay the former at higher concentrations. Only the lyophilized aqueous extract produced a slight hypotensive effect when given intravenously at 150 mg/kg to urethananesthetized rats.     

Effectiveness of health education for puerperae

A survey was conducted in early 1985 among 366 new mothers at 3 hospitals in Pinar del Rio, Cuba, to assess their level of health information regarding the care of newborns. The 11 study variables included breastfeeding, weaning, bathing the newborn, care of clothing and equipment for the baby, well baby visits, vaccination, accidents and safety, parent-child relations, sex education, and the puerperium. The level of information on these topics was generally low and was adequate only for breastfeeding. The information deficit was not related to urban or rural residence, parity, or educational level. The lack of knowledge of new mothers was attributed to the lack of motivation of health personnel at all levels to provide health education, inadequate use of existing information channels, and a lack of emphasis on health education within the general educational system.     

Cross-correlation analysis of septohippocampal neurons during theta-rhythm

The activity from 55 septohippocampal neuron pairs was examined in rats anesthetized with urethane. In addition to the statistical characterization of the firing patterns of the recorded units, the functional interactions between pairs of neurons and between neurons and hippocampal theta (theta) waves were investigated with cross-correlation techniques. Pairs were classified according to the rhythmic or non-rhythmic discharge pattern of their neurons. (a) theta-Pairs were those in which both the medial septal (MS) and hippocampal (HPC) units were rhythmic (type 1 units). (b) Pairs with a rhythmic and a theta-related non-rhythmic unit (type 2 unit) were called mixed pairs. (c) Pairs composed of type 2 units were called type 2 pairs. theta-Pairs showed periodic cross-correlations and frequently fired with a phase difference which could change in different pairs. Mixed pairs also showed periodic cross-correlations although one of the units was non-rhythmic. Type 2 pairs showed non-periodic positive cross-correlations. Our data provide new information regarding the temporal relationship between MS and HPC rhythmic activities supporting the role of the MS in providing the afferent timing for the generation of theta-rhythm in the HPC.