Pericholecystic fistula: a study of 64 cases

Spontaneous biliary fistulas are found quite often. Although previously considered as a contraindication to laparoscopic surgery, they are now being treated laparoscopically with all its advantages. Of 8015 patients undergoing laparoscopic cholecystectomy, 64 patients were diagnosed preoperatively; conversion to open surgery was required in 8 patients. The highest incidence of pericholecystic fistulas was found in the >60-year age group. The postoperative stay ranged from 3 to 8 days. All the patients were well at follow up. Laparoscopic management of pericholecystic fistulas is possible with low morbidity and no mortality.     

Modification of glutamate binding sites in newborn brain during hypoglycemia

We have shown that acute insulin-induced hypoglycemia leads to specific changes in the cerebral NMDA receptor-associated ion channel in the newborn piglet. The present study tests the hypothesis that exposure to acute hypoglycemia in the newborn will alter the glutamate binding site of both NMDA and kainate receptors. Studies were performed in 3-6 days-old piglets randomized to control (n=6) or hypoglycemic (n=6) groups. Hypoglycemia was maintained for 120 min using insulin infusion. Saturation binding assays were performed in cerebral cell membranes using (3)H-glutamate or (3)H-kainate to determine the characteristics of the glutamate binding sites of the NMDA and kainate receptors, respectively. The concentration of glucose in cerebral cortex was 10-fold less in hypoglycemic piglets than in controls (P<0.05). Brain ATP was not significantly decreased during hypoglycemia, but phosphocreatine decreased from control of 6.6 +/- 1.3 micromoles/g brain to 3.2 +/- 1.9 micromoles/g brain in hypoglycemic piglets. The B(max) for NMDA-displaceable (3)H-glutamate binding was 992 +/- 64 fmol/mg protein in hypoglycemic animals, significantly higher than the control value of 746 +/- 42 fmol/mg protein. However, the dissociation constant for glutamate was unchanged during hypoglycemia. The (3)H-kainate binding studies demonstrated no change in B(max) of high-affinity kainate receptors during hypoglycemia. In contrast, the affinity of the kainate receptor glutamate binding site significantly increased compared to control. Thus, acute hypoglycemia in the newborn piglet had specific effects on the glutamate binding sites of the NMDA and kainate receptors that could be due to alterations in cell membrane lipids or modification of receptor proteins.     

Eosinophilic lung disease in the tropics

Paul Ehrlich first described the eosinophil in 1879. It is a pro-inflammatory cell that is involved in the immune defense against various offenders in atopic and nonatopic individuals. Eosinophils derive from an unknown progenitor cell in the bone marrow. This article reviews the etiology and effects of this condition.     

Primary renal lymphoma and xanthogranulomatous pyelonephritis in childhood

Primary renal non-Hodgkin's lymphoma is very rare in childhood. A six-year-old boy presented with bilateral non-obstructive multinodular nephromegaly and renal failure. Percutaneous needle biopsy showed large-cell lymphoma. The patient was started on chemotherapy. A right nephrectomy was done when systemic hypertension developed in the presence of a non-functional right kidney. Histopathologic examination revealed focal lymphomatous infiltration and xanthogranulomatous pyelonephritis which is an atypical form of chronic renal infection. The case is discussed in relation to previons reports.     

A randomised controlled trial comparing Triadcortyl® with 10% glycerine–ichthammol in the initial treatment of severe acute otitis externa

Acute otitis externa is a common clinical condition accounting for a large proportion of patients attending the otolaryngology department, although milder cases are often managed in primary care. Treatment of the most severe forms of otitis externa involves aural toilet, followed by the application of a topical preparation, commonly in the form of an ear canal dressing. A prospective single-blind randomized controlled trial was performed to compare the efficacy of 10% glycerine-ichthammol (GI) solution and Triadcortyl((R)) (TAC) ointment, both applied as ear canal dressings, in the initial management of severe acute otitis externa. A total of 64 patients were studied. Both treatment modalities were proven efficacious in the treatment of severe acute otitis externa. Although there was a statistically significant improvement of pain parameters in the TAC group, we found no significant differences in clinical findings between the two groups. Therefore, it is recommended that GI dressing can be used instead of an antibiotic dressing as an initial treatment of severe acute otitis externa on the basis of cost, avoidance of resistance and toxicity.     

Pericardial involvement in familial Mediterranean fever

Two patients with familial Mediterranean fever showed the classic features of pericardial involvement and one of them (Case 2) had pericardial effusion detected by echocardiography. These and previously published cases show that familial Mediterranean fever should be considered as a cause of pericarditis and/or pericardial effusion.     

Assessment of anti-reserpine and anti-apomorphine activities of some psychic energizers in pigeons

Summary Seven psychic energizers have been quantitatively evaluated for their antidepressant and tranquillizing activity using antagonism of reserpine induced emesis and apomorphine induced pecking in pigeons as test procedures for the two activities respectively. Pheniprazine and deanol possess anti-reserpine activity only whereas imipramine, desmethylimipramine, amitriptyline, opipramol and orphenadrine possess both anti-reserpine as well as anti-apomorphine activity. It is suggested that the two tests form a simple and reliable combination for evaluating potential antidepressants.This work was presented in part at the XI Annual Conference of the Association of Physiologists and Pharmacologists of India held at Lucknow in 1965.     

Axenfeld-Rieger syndrome: report on dental and craniofacial findings

Axenfeld-Rieger syndrome is a rare autosomal dominant disorder characterized by various ocular and extraocular malformations. Dental abnormalities are considered as definitive features for the diagnosis and differentiation of Rieger syndrome from other anterior chamber of the eye malformations. A case of Rieger syndrome with distinct dental and craniofacial anomalies is described. Significant cranio-dento-facial findings that have been observed are, teeth with short and dilacerated roots, hyperplastic frenums and underdeveloped maxilla. There was an anterior crossbite, bilateral posterior open-bite and moderate to severe anterior crowding.     

Calculation of magnetic field-induced current densities for humans from EAS countertop activation/deactivation devices that use ferromagnetic cores

Compliance testing of electronic article surveillance (EAS) devices requires that induced current densities in central nervous system (CNS) tissues, i.e. brain and the spinal cord, be less than the prescribed safety limits. Even though ferromagnetic cores are mostly used for activation/deactivation of embedded magnetic tags, assumed equivalent air-core coils with guessed increased number of ampere turns have always been used to calculate the magnetic fields for the proximal region to which a customer is exposed. We show that at low frequencies up to several kilohertz, duality of electric and magnetic circuits may be exploited such that the shaped high reluctance core is modelled as though it was a higher conductivity electric circuit of the corresponding shape. The proposed procedure is tested by examples of two magnetic cores typical of countertop activation/deactivation devices. The equivalent exposure magnetic fields obtained from the dual electric fields are shown to be in excellent agreement (within +/-5%) with those measured for these ferromagnetic EAS devices. The previously proposed impedance method is then used to calculate the induced current densities for a 1.974 x 1.974 x 2.93 mm resolution anatomic model of a human. For the two considered EAS systems using excitation currents of 5000 A turns at 200 Hz, the maximum 1 cm2 area-averaged induced current densities in the CNS tissues are calculated and found to be less than the ICNIRP safety limits.