Perineal repair of rectal procidentia with an elastic fabric sling

The use of a Dacron®-reinforced Silastic® graft in the perineal repair of rectal procidentia offers a simple technique for elderly and debilitated patients. Experience with this procedure in nine patients, followed for two years, indicates that this elastic material appears to have substantial advantages over wire or synthetic mesh in the perineal repair of rectal procidentia.     

Colonic motility in man: features in normal subjects and in patients with chronic idiopathic constipation

The human colon is still a relatively unknown viscus, especially concerning its motor activity. However, in recent years, techniques have been perfected that allow a better understanding of colonic motility, especially through prolonged recording periods. In this way, it has been demonstrated that the viscus contracts according to a circadian trend, is responsive to physiological stimuli (meals, sleep), and features high amplitude, propulsive contractions that are part of the complex dynamic of the defecatory process. These physiological properties and their alterations in patients with chronic idiopathic constipation are reviewed in this article.     

Oral ondansetron (GR 38032F) for the control of CMF-induced emesis in the outpatient

Summary The efficacy of the serotonin antagonist ondansetron (GR 38032F) was evaluated in the prevention of nausea and vomiting induced by CMF chemotherapy in 29 breast cancer patients. At their first treatment course of CMF, all given IV on day 1 q 21 days, patients were given oral antiemetic treatment as follows: ondansetron 8 mg, 2 h prior to CMF, repeated after 5 and 10 h the day of chemotherapy and then 8 mg tds for a minimum of 3 days to a maximum of 5 days following chemotherapy. At first course of CMF, complete protection from emesis and nausea was observed in 86.2% and 62% of patients, respectively. At subsequent CMF courses with ondansetron, complete control of emesis was observed in 80% of patients. Side effects were mild and no dystonic reactions were observed. Ondansetron represents an effective, safe, and easily administered outpatient regimen. The addition of a corticosteroid to ondansetron could further improve control of CMF-induced emesis.     

Synovial chondromatosis of the hip evaluation with air computed arthrotomography

Four patients with primary synovial chondromatosis of the hip were evaluated with air or double contrast computed arthrotomography. Air computed arthrotomography was an easy and accurate method of diagnosing the disease and delineating its anatomic extent. The use of air as a sole contrast agent allowed noncalcified chondromatous nodules to be identified. It prevented faintly calcified nodules from being obscured by positive contrast, and was a better means of assessing the narrow portions of the hip joint.

Accurate diagnosis of this disease and its extent was demonstrated using air computed arthrotomography. This method provided the most complete preoperative data for the orthopaedic surgeon.     

Rathke's cleft cyst: a clinical and radiographic review

We report the case of a 62-year-old woman, who had a 4-year history of progressive visual acuity deficit. On neurological examination, visual acuity was 5/20 in the right and 4/20 in the left eye. A hormonal study revealed hypophyseal hypofunction. CT and MRI scans showed an intra-suprasellar cystic lesion, hyperintense in T1 and hyperintense in T2-weighted sequences. At surgery, the cyst wall was opened and the cavity placed in communication with the subarachnoid space. Histological examination showed a Rathke's cleft cyst. After four years of follow-up the patient's visual deficit remained unchanged, whereas the results of the hormonal assays were normal. An MRI scan confirmed the absence of the cyst. We review 216 reported cases of Rathke's cyst and discuss its pathogenesis, clinical features and treatment.     

A two-step supraorbital approach to lesions of the orbital apex. Technical note.

A two-step supraorbital approach to lesions of the orbital apex is described. This technique is easy and allows a satisfactory exposure of the region. In addition, the reconstruction resulting from the procedure is anatomically perfect. The authors report the operative results obtained in 20 patients and compare this two-step supraorbital procedure with similar surgical techniques described previously.     

Late intraneural metastasis of the brachial plexus from mammary carcinoma. Report of a case

A rare case of late intraneural metastasis of the brachial plexus from mammary carcinoma is reported. The lesion was strictly intraneural and had a latency of 29 years and the diagnosis was made incidentally in the course of surgery. The clinicopathological and diagnostic features of the tumor are discussed in the light of the accessible literature.