Calcium absorption following small bowel resection in man. Evidence for an adaptive response

Seventeen patients who had undergone extensive small bowel resection were studied for calcium absorption (FACa) and plasma vitamin D metabolites. FACa was measured by a double radio-tracer technique and expressed as percentage of total oral dose. FACa was decreased compared with controls (34%, range: 3-46 v 65%, range: 57-73, P less than 0.01). A positive correlation (r = 0.49, P = 0.05) was found between FACa and the remaining length of small bowel (SBL). As wide variations in both SBL and duration after surgery were observed among the seventeen investigated patients, we were led to individualize less heterogeneous subgroups of patients. Better correlations were found when the patients were divided into two subgroups according to whether the time interval between the resection and the investigation was shorter (r = 0.75, n = 11, P less than 0.02) or longer (r = 0.89, n = 6, P = 0.05) than 2 years. In thirteen patients who had a SBL shorter than 100 cm, a positive correlation was observed between FACa and the time interval after surgery (months): r = 0.65, P less than 0.05. Plasma 1,25 (OH)2D was markedly reduced in the whole group (31 pmol l-1, range: 8-108) compared with controls (103 pmol-1, range: 59-134, P less than 0.01). The present study shows that in extensively small bowel resected patients, calcium absorption is reduced, the alteration being dependent both on the length of the remnant small bowel and on the time after surgery.(ABSTRACT TRUNCATED AT 250 WORDS)     

The late results after axillo-femoral bypass grafts in patients with leg ischaemia

The late results--up to six years--after axillo-femoral bypass reconstruction are reported for 85 patients with leg ischaemia who were regarded as poor-risk patients for aortic bypass surgery, or who had aortic graft infection. Velour-Dacron grafts and expanded polytetrafluoroethylene (PTFE, Gore-Tex)--grafts have been used. The cumulative patency rate (life table) six years after graft implantation was 64% (PTFE-grafts) and 58% (Velour-Dacron grafts). The corresponding cumulative limb salvage rate six years after graft implantation was 88% when PTFE grafts were used and 77% when Velour-Dacron grafts were used. Our results demonstrate that axillo-femoral reconstruction is a useful procedure with a good patency rate 6 years after implantation. This procedure should be considered when dealing with poor risk patients with severe leg ischaemia.     

A comparative study of the tissue-destroying effect of the laser and electrocoagulation

The effect of the laser on compact, glandular tissue at the dosage employed for the local palliative treatment of tumors, can largely be mimicked with the aid of high-frequency current (HF-current), applied with the aid of an electro-hydro-thermo-probe: The experiments described in the present study were performed on the livers of 70 male Wistar rats. The laser was applied for 2 seconds at an output of 80 J at a distance to the tissue of 0.5 cm. In the first stage, in the acute experiment, the effect of the HF-current was matched to that of the laser by varying the modulated and unmodulated current components. It was found that the depths of penetration into the tissue at the given laser settings could be achieved with modulated HF-current (so-called coagulation current) at an output of more than 72 watts (equipment setting K 10) coagulation being performed for 10 seconds. The admixture of modulated HF-current (so-called cutting current) reduces the depth of penetration into the tissue. In the first 5 days, the depth of penetration increases after both laser irradiation and HF-coagulation, by a factor of 2 to 3. With respect to the depths of penetration (DP), the scatter ranges, and the histological changes, no difference is to be seen between laser and HF lesions: Laser DP = 5.7 mm (confidence range: 4.4-7.0 mm); HF DP (equipment setting K 10) = 4.8 mm (confidence range: 3.6-5.4 mm).(ABSTRACT TRUNCATED AT 250 WORDS)     

Are ADDH and ADHD the same or different?

To assess the relationship between the DSM-III criteria for attention deficit disorder with hyperactivity (ADDH) and the DSM-III-R criteria for attention-deficit hyperactivity disorder (ADHD), children from an inner city parochial school were evaluated using a 30-item teacher questionnaire consisting of the DMS-III and DSM-III-R criteria for these disorders, the revised Conners Parent and Teacher Questionnaires, and a continuous performance test. Diagnostic groups were established based on teacher ratings of the DSM items and evaluated in relation to the rating scale data and continuous performance test. While children who were identified by teachers as having ADDH almost always satisfied the criteria for ADHD, a new group of children who were hyperactive and impulsive but less clearly inattentive also met the criteria for ADHD. Implications of the change in diagnostic criteria are discussed.     

Diabetic retrobulbar optic neuropathy

The authors describe a case of retrobulbar optic neuropathy in a patient with type 1 Diabetes mellitus. In spite of good metabolic control, there has been a slow but progressive functional visual decline. Worthy of note is the abnormal precocity of the appearance of the functional damage of the optic nerve compared to the involvement of the peripheral system.