Histology as a prognostic factor in early gastric cancer.

Of 431 patients with gastric cancer observed in our institution, 23 (5.3%) had early gastric cancer (EGC). Macroscopic presentation, histology, depth of invasion, and lymph node involvement were evaluated in all the cases. All patients underwent surgery and an intensive follow-up was performed. Five of the 23 patients progressed, and the risk factors were examined. Histology seemed to be the main prognostic factor in our study, since intestinal type of EGC was associated to a significantly better prognosis. Total gastrectomy is indicated in the proximal localization of EGC, and should perhaps be performed also in cases presenting undifferentiated histology.     

Anticarcinogenic action of diallyl sulfide in hamster buccal pouch and forestomach.

The anticarcinogenic action of the garlic constituent diallyl sulfide (DAS), was examined in the hamster buccal pouch and forestomach. Groups of hamsters were topically treated, for up to 14 weeks, with a 0.5% solution of the buccal pouch and forestomach carcinogen 7,12-dimethylbenz[a]anthracene (DMBA). Prior to, during and after DMBA treatment, groups of hamsters were also treated, on alternate days, with a 1% solution of DAS. In addition to tumor formation, the induction of gamma-glutamyl transpeptidase (gamma GT) buccal pouch epithelial lesions served as an additional presumptive index of in vivo carcinogenesis/anticarcinogenesis. DAS resulted in a significant reduction in buccal pouch tumor frequency, buccal pouch tumor burden, buccal pouch gamma GT lesion frequency and forestomach tumor frequency. In a separate experiment, DAS also reduced the level of autoradiographically quantified unscheduled DNA repair synthesis (UDS) in pieces of hamster buccal pouch concurrently exposed in vitro to the potent buccal pouch carcinogen N-methyl-N-benzylnitrosamine (MBN). This study demonstrates that DAS is an effective anticarcinogenic agent in squamous mucosa of the hamster and suggests novel cost-effective strategies for the rapid identification of tissue-specific anticarcinogens and a quantitative assessment of their efficacy.     

Assessment of post-vaccination tuberculin sensitivity in Lagos-Nigeria.

An increase in the number of cases of tuberculosis, especially in children, has been observed recently. Post-vaccination conversion rate in babies immunised with BCG was assessed. Sensitization was detected as early as 4 weeks after BCG inoculation. Although 84.2% had physical evidence of BCG inoculation only 69.8% had developed detectable sensitization to the tubercle bacilli as shown by the Mantoux test.     

Pneumonia complicating abdominal sepsis: an experimental model of hematogenous contamination of the lung.

Pulmonary infection complicating intra-abdominal sepsis is a major clinical problem. An experimental model for intra-abdominal sepsis was created with implantation of gelatin capsules, containing 3 x 10(8) cfu E. coli strain no. 2554, in the peritoneal cavity of 20 rats (10 animals received and 10 did not receive antibiotic therapy with ceftriaxone) in order to verify the role of the primary site of infection in the pathogenesis of pneumonia. Ten rats were sacrificed to determine the relative pulmonary weight and 10 were submitted to simple laparotomy and insertion of a germ-free capsule (sham-operated group). In this group of animals there was only one death (10%). All the rats that received antibiotic therapy survived until sacrifice while all the rats that did not receive ceftriaxone died, 7 within the 2nd and 3 on the 6th postoperative day. Pneumonia and peritonitis developed only in the animals that did not receive ceftriaxone. Bacteriological findings of material obtained from peritoneal and pleural cavities revealed the same strain of E. coli used for the experiment, suggesting that bacteria involved in the pleuro-pulmonary infections may originate in the primary site of infection and that antibiotic therapy started at the moment of contamination, can prevent this major complication.     

LUMBOVERTEBRAL SYNDROME AFTER EXTRADURAL BLOOD PATCH

We describe a patient who developed an immobilizing lumbovertebralsyndrome after an extradural blood patch and who was hospitalizedwith a. suspected extradural abscess. An infectious aetiologyof the persistent backache could be excluded and the patientrecovered with analgesics and physiotherapy. The probable aetiologyis discussed.     

Electromyographic activity while performing the anti-G straining maneuver during high sustained acceleration.

The purpose of this study was to measure the muscle activity during performance of the anti-G straining maneuver (AGSM) at high sustained acceleration stress (+Gz = head-to-foot inertial loading). Ten males were exposed on three separation occasions to a rapid onset rate of 6 + Gz. Subjects wore standard United States Air Force (USAF) anti-G trousers and performed the AGSM until perceived fatigue or until achieving light loss criteria. During each exposure, surface electromyography (EMG) was recorded from the erector spinae, external oblique, bicep femoris, vastus lateralis, and lateral gastrocnemius muscles. The normalized root-mean squares (RMS) and mean power frequency (MPF) for each muscle were calculated and tested for significant differences with an analysis of variance (ANOVA) procedure. The results of this study showed that mean amplitude decreased during the AGSM (35.40%) while MPF showed no significant change. The EMG amplitude of lower extremity muscles decreased (61.45%) while the amplitude of trunk muscles decreased slightly (3.45%). These results indicate that during the performance of the AGSM, motor unit recruitment in lower extremity muscles decrease without evidence of fatigue.     

AVIATION NURSING IN THE WESTERN AUSTRALIAN KIMBERLEY

ABSTRACT: This article provides a brief overview of the Western Australian (WA) Kimberley Royal Flying Doctor Service and the role of the flight nurse who accompanies patients requiring aerial medical evacuation from rural and remote WA. Two short case histories of head injured patients evacuated from the Kimberley region will be outlined and some of the potential concerns associated with transferring patients at altitude in a confined and altered working environment will be discussed.