Noise pollution in the operating room: a hazard to surgeons, personnel, and patients.

Noise levels up to 118 dB--a level that is potentially damaging to the hearing--were measured in the operating room, notably during the use of high-speed gas turbine bone-cutting drills. Suction tips, which had trapped tissue "whistles" inside, yielded noise levels of up to 96 dB. Surgeons, staff, and patients should be cautioned against such noises and shielded in prolonged cases. We offer a review of acoustical criteria for various practical noises and duration of safe exposure.     

Cytomegalovirus cecal erosion causing massive hemorrhage in a bone marrow transplant recipient

A 24-year-old male underwent bone marrow transplantation for severe aplastic anemia. Posttransplantation complications included severe graft-versus-host disease and cytomegalovirus (CMV) infection manifested by gastrointestinal bleeding and apparent pneumonitis. Massive rectal bleeding necessitated exploratory laparotomy at which time a right colon resection was performed. Fifteen cecal ulcers were present which on histologixc examination revealed numerous cells containing characteristic intranuclear inclusions. Life-threatening gastrointestinal lesions associated with CMV infection will be seen with increasing frequency as more patients undergo the severe immunosuppression associated with bone marrow and organ transplantation. Prompt recognition and expeditious surgical management will result in improved survival in this high-risk population.

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Résumé Chez un sujet de 24 ans qui avait subi une transplantation de moelle osseuse sort survenues des complications de rejet et une infection à cytomégalovirus qui s'est manifestée par une hémorragie digestive et une atteinte pulmonaire. L'abondance de l'hémorragie a imposé une laparotomie exploratrice qui a conduit à une hémicolectomie droite. Sur la pièce de résection on a découvert quinze ulcérations. L'examen histologique a montré qu'elles contenaient de nombreuses cellules dont le noyau présentait de nombreuses inclusions caractéristiques.Ce type de lésions digestives allant de pair avec une infection a cytomégalovirus devrait devenir de plus en plus fréquent chez les malades qui présentent des phénomènes immuno-dépressifs après transplantation d'organes ou de moelle osseuse. Il sera nécessaire de les reconnaitre rapidement pour les traiter chirurgicalement sans retard. C'est à ce prix que le risque d'évolution fatale pourra être réduit chez ces sujets à haut risque.

     

Malignant tumors of the nasopharynx

One hundred and twenty patients with malignancy of the nasopharynx were reviewed. The most common presenting symptoms of this disease were cervical mass and hearing loss. Neoplasm occurred three times more frequently in males than in females. Cranial nerve dysfunction was present in 17.5% of patients at the time of initial evaluation. The overall 3- and 5-year determinate survival for the entire series of nasopharyngeal malignancies was 38.9, and 27.0%, respectively. Nonsquamous cell malignancies demonstrated a better 5-year survival (42%) than squamous cell and undifferentiated neoplasms (24%). The presence of cervical metastases offered a poorer prognosis. A 39.6% 5-year survival was recorded for patients without nodal disease. Massive lymphadenopathy or bilateral cervical metastases forecasted an ominous 5-year survival of 13.6%. Control rate was greatest among patients with tumors restricted to one area of the nasopharynx and without regional metastases. The 5-year survival of such patients was 71.4% compared to 13.3% for patients having tumor extension beyond the nasopharynx producing cranial nerve impairment or bone erosion.     

Effects of copper on the sabellid polychaete,Eudistylia vancouveri: I. Concentration limits for copper accumulation

Three experiments with a sabellid polychaete (Eudistylia vancouveri) show the threshold concentration for increasing copper accumulation with time to lie between 3 and 6 g/L total copper in seawater during winter conditions. The branchial crown, probably the major absorptive site, concentrated more copper than the body. Accumulation was influenced by size but not by sex. Our studies indicate that the body burden of copper will increase above natural levels in areas of industrial discharge where copper levels are above the threshold limit for accumulation.     

Axoplasmic transport blockage therapy in herpes zoster ophthalmicus

Three patients with herpes zoster ophthalmicus were treated with an oral administration of colchicine and corticosteroid, while another seven were given systemic corticosteroid, vitamins, and sedatives. Colchicine inhibited the formation of new skin lesions but did not suppress the already grown vesicles. The effect of colchicine was attributed to a blockage of intra-axonal dissemination by neurotrophic virus.     

Cost analysis of a Laboratory Information System (LIS)

The cost of building, installing, and maintaining a full hospital laboratory communication system is expensive. Using an outside accountant, our books were audited to determine the expenses in each of our major cost centers. These data are tabulated along with services provided. Although the initial expenditures are high, the actual cost per test for full service capability is somewhere between 13 and 17 cents. If viewed as a cost per patient day, the price ranges between 59 and 85 cents.     

Neuronal differentiation and morphological integration of hippocampal progenitor cells transplanted to the retina of immature and mature dystrophic rats

Attempts to repopulate the retina with grafted neurons have been unsuccessful, in large part because donor cells prefer not to integrate with those of the host. Here we describe the first use of neural progenitor cells in the diseased adult retina. Adult rat hippocampal progenitor cells were injected into the eyes of rats with a genetic retinal degeneration. After survival times up to 16 weeks, the retinae of 1-, 4-, and 10-week-old recipients exhibited widespread incorporation of green fluorescent protein-expressing (GFP+) donor cells into the host retina. The 18-week-old recipients showed a similar pattern, but with fewer cells. Grafted cells expressed the mature neuronal markers NF-200, MAP-5, and calbindin. GFP+ cells extended numerous neurites into the host plexiform layers and these processes were intimately associated with synaptophysin+ profiles. GFP+ neurites also extended into the host optic nerve head. These results demonstrate the differentiation of substantial numbers of new neurons within the mature dystrophic retina.     

Enterogenous cyst of the posterior fossa

We report the case of a 13-year-old boy who presented with deafness due to a posterior fossa cystic lesion which was surgically excised. Histological examination showed it to be an enterogenous cyst. These extremely rare lesions seldom occur within the neural axis.