Comparative study of the holding strength of slipknots using absorbable and nonabsorbable ligature materials

The holding and tensile characteristics of five extracorporeal slipknots in relation to absorbable and nonabsorbable ligature materials have been evaluated in a standardized in vitro test rig. The knots studied: Tayside, Roeder, Melzer (modified Roeder), Cross square, and Blood knots were tied with the following materials: silk, polyamide, Dacron, polydioxanone (PDS), and lactomer (Polysorb). Following construction and slippage (run down) to a fixed-diameter loop around a cylinder, the knots were locked (tightened) using a standardized force after which they were removed from the test rig and subjected to holding strength (force required to induce reverse slippage) and other tensile characteristics (stress, strain, elasticity) by a tensiometer. Analysis of the data has demonstrated the following: (1) The safest slip knots (resist slippage) are the Tayside, Melzer, and Roeder knots tied with lactomer and Dacron. (2) The holding strengths of the Cross square and Blood knots are weak with all ligature materials tested. (3) Polydioxanone is a safe ligature material for the Melzer and Tayside but not the Roeder knot. (4) Extracorporeal slipknots tied with silk and polyamide are less secure than the equivalent knots tied with Dacron, lactomer, and polydioxanone.     

Milk intake and survival in newborn cannabinoid CB1 receptor knockout mice: evidence for a "CB3" receptor

Cannabinoids, whether plant-derived, synthetic or endogenous, have been shown to stimulate appetite in the adult organism. We have reported previously that cannabinoid receptors play a critical role during the early suckling period: The selective cannabinoid CB(1) receptor antagonist N-(piperidiny-1-yl)-5-(4-chlorophenyl)-1-(2,4-dichlorophenyl)-4-methyl-1H-pyrazole-3-carboxamide (SR141617A) permanently prevented milk ingestion in a dose-dependent manner, when administered to (Sabra, albino) mouse pups, within 1 day of birth. As a consequence, these pups died within the first week of life. We now generalize this finding to a different strain of mice (C57BL/6). Further, we show that cannabinoid CB(1) receptor blockade (20 mg/kg SR141716A) must occur within 24 h after birth as injection of SR141716A into 2- or 5-day-old pups had a much smaller effect or no effect at all, respectively. Cannabinoid CB(1) receptor knockout mice did not ingest milk on the first day of life, similarly to SR141716A-treated normal pups, as measured by the appearance of "milkbands". However, the knockout pups started to display milkbands from day 2 of life. Survival rates of cannabinoid CB(1) receptor knockout mice were affected significantly, but to a lesser extent than normal pups, by the administration of SR141716A. Daily administration of the endocannabinoid 2-arachidonoyl glycerol, or the synthetic agonists (R)-(+)-[2,3-dihydro-5-methyl-3-(4-morpholinylmethyl)pyrrolo[1,2,3-de]-1,4-benzoxazin-6-yl]-1-naphthalenylmethanone (WIN55,212-2, 5 mg/kg) or (-)-cis-3-[2-Hydroxy4-(1,1-dimethylheptyl) phenyl]-trans-4-(3-hydroxypropyl)cyclohexanol (CP55,940, 5 or 20 mg/kg) did not promote survival or weight gain in CB(1)(-/-) pups. Our data support previous evidence for a critical role of cannabinoid CB(1) receptors for the initiation of suckling. Further, the present observations support the existence of an unknown cannabinoid receptor, with partial control over milk ingestion in newborns. Our data also suggest that the CB(1)(-/-) neonates possess a compensatory mechanism which helps them overcome the lack of cannabinoid CB(1) receptors.     

Endoscopic oesophagectomy through a right thoracoscopic approach.

A technique of subtotal endoscopic oesophagectomy through the right thoracoscopic approach is described. It has been used in five patients, four with cancer and one with benign motility disorder. The operative blood loss during the endoscopic dissection stage was unmeasurable in four patients and amounted to 300 ml in one. The mean (range) duration of the endoscopic dissection was 3.3 (3.0-4.0) h and of the total procedure was 5.5 (4.5-7.5) h. After the operation, the mean (range) duration of stay in the intensive care unit was 19.5 (16-26) h. From the time of the operation, the mean (range) hospital stay was 11 (8-18) days. One patient developed left vocal cord palsy which prolonged this.     

A microprocessor-controlled psychomotor tester for minimal access surgery

Background: There is little reported information on psychomotor performance in relation to minimal access surgery (MAS). Methods: A microprocessor-controlled endoscopic psychomotor tester (the Dundee Endoscopic Psychomotor Tester—DEPT) has been developed to evaluate psychomotor aspects of MAS. Experiments were conducted on 20 medical undergraduates to evaluate accuracy and reliability of the tester. Results: The study demonstrated a significant difference between subjects (p < 0.01). It also identified three individuals who enacted 16, 22, and 40 errors while the majority (85%) sustained less errors with a median of 4.5. Conclusions: DEPT provides a standard, reproducible, objective real-time scoring system. It identifies individuals who cannot adjust to endoscopic viewing and therefore manipulate from endoscopic images.     

Computer Simulation of Heat Transfer in Different Tissue Layers of Body Extremities Under Heat Stress in Deep Anesthetic Condition

Many mathematical models of thermoregulation in humans have been developed, so far. These models appeared to be very useful tools for studying temperature regulation in humans under adverse environmental conditions. However, no one discussed the heat transfer characteristics of denervated subjects. Thus, the present study is concerned with aspects of the passive system for denervated subjects: (1) modeling the human body extremities (2) modeling heat transport mechanism within the body and at its periphery. The present model was simulated using the software (Wintherm 8.0, Thermoanalytics, USA) for different body segments to predict the heat flow between body core and skin surface with changes in environmental temperature with fixed relative humidity and wind velocity. The simulated model for comparative study of internal temperature distribution of hand, arm, leg and feet segments yielded remarkably good results and observed to be in trends with previously cited work under ambient environmental condition and at controlled room temperature. Models could be used to measure the temperature distribution in human limbs during local hyperthermia and to investigate the interaction between limbs and the thermal environment.     

Parasitic infections on the shore of Lake Victoria (East Africa) detected by Mini-FLOTAC and standard techniques

Background

Helminths and protozoa infections pose a great burden especially in developing countries, due to morbidity caused by both acute and chronic infection. The aim of our survey was to analyze the intestinal parasitic burden in communities from Mwanza region, Tanzania.

Methods

Subjects (n = 251) from four villages on the South of Lake Victoria have been analyzed for intestinal parasites with direct smear (DS), formol-ether concentration method (FECM) and the newly developed Mini-FLOTAC technique; urinary schistosomiasis was also assessed in a subsample (n = 151); symptoms were registered and correlation between clinic and infections was calculated by chi-squared test and logistical regression.

Results

Out of the subjects screened for intestinal and for urinary parasites, 87% (218/251) were found positive for any infection, 69% (174/251) carried a helminthic and 67% (167/251) a protozoan infection, almost half of them had a double or triple infection. The most common helminths were hookworms, followed by Schistosoma mansoni and Schistosoma haematobium. Among protozoa, the most common was Entamoeba coli followed by Entamoeba histolytica/dispar and Giardia intestinalis. Mini-FLOTAC detected a number of helminth infections (61.7%) higher than FECM (38.6%) and DS (17.9%). Some positive associations with abdominal symptoms were found and previous treatment was negatively correlated with infection.

Conclusion

Despite the limited size of the examined population the current study indicates a high prevalence of intestinal parasitic infection in Bukumbi area, Tanzania, and Mini-FLOTAC showed to be a promising diagnostic tool for helminth infections. This high parasitic burden calls for starting a regular deworming programme and other preventive interventions in schools and in the community.     

Improved lipid profile in ovariectomized rats by red ginseng extract

The effects of red ginseng extract on lipid metabolism were examined in ovariectomized rats. Twenty-four female Sprague-Dawley rats (210 +/- 20 g) were studied for 10 weeks. The rats were divided into four groups: (I) "sham" non-ovariectomized rats treated with olive oil, (II) control ovariectomized rats treated with olive oil, (III) ovariectomized rats treated with 0.5 mg/kg 17beta-estradiol in olive oil, and (IV) ovariectomized rats treated with 5mg/kg red ginseng extract in olive oil. Red ginseng extract induced significant reductions in total cholesterol, low density lipoprotein cholesterol/total cholesterol, high density lipoprotein cholesterol/total cholesterol, and low density lipoprotein cholesterol/high density lipoprotein cholesterol, implying the effectiveness of ginseng in targeting postmenopausal symptoms.     

Dislocation of the carpometacarpal joint of the thumb associated with trapezium and Bennett's fractures

We report a case of a carpometacarpal joint dislocation of the thumb associated with trapezium and Bennett's fractures. This combined injury pattern appears to be very rare. To our knowledge, no such case was found in the literature. The patient had open reduction internal fixation with pins and screws, with good functional outcome.