Although intra-abdominal lymphangioma and mesenteric cysts are rare benign tumours, they have to be considered in the differential diagnosis of abdominal pain. Differentiation of these lesions is important, because lymphangiomas may follow a proliferative and invasive course. From 1979 to 1993 four patients with intra-abdominal cystic lymphangiomas and two with mesenteric cysts underwent operations in our surgical department. Five of these six patients had abdominal symptoms, ranging from unspecific abdominal pain to acute clinical abdomen. In all cases surgical enucleation or resection and histological classification were necessary before final diagnosis was possible.

In the selection of patients for mitral commissurotomy, accurate assessment of the amount of mitral regurgitation on a clinical basis may be extremely difficult (1). Hence, the indicator dilution techniique, which offers some possibility for detection and a quantification of the regurgitant flow, has been widely applied to this problem in patients (2-5). However The shunt consisted of a polyviinyl tube, 4 mm. internal diameter and 31 cm. long with a "Y" tube in the middle, so that a side tube could be led off and attached to a reservoir. The shunt was introduced into the left auricle after the tip of the left auricular appendage had been removed; the other end was introduced into the left ventricle through a stab wound in the apex and both were fastened in by purse-string sutures. (Figure 1 shows the shunt in place.) To measure shunt flow, both limbs of the shunt, that is, to the left auricle and to the reservoir were unclamped, the reservoir was set at left auricular level and the limb leading into the auricle was clamped. Flow was then measured into the reservoir for 10 seconds or 50 ml. This amount of blood loss did not alter blood pressure and blood was immediately returned to the dog. Shunt flow was measured before and after all cardiac output determinations done with the shunt open. With this size shunt, the regurgitant flow varied between 20 and 38 per cent of the forward flow, forward flow being measured by the dye dilution technique.Cardiac outputs were done using the dye dilution method of Stewart and Hamilton (6) with 5 ,uc. of radioactive iodinated human serum albumin in 0.5 ml. of saline as the indicator. The amount injected was determined by weighing the syringe before and after injection. For the left auricular (LA) injections, a saline-filled, 2 ml. capacity polyethylene tube was attached to the auricular catheter. This was filled with the indicator through one limb of a three-way stopcock, and then the contents rinsed in as rapidly as possible with a 10 ml. saline rinse through the other limb of the stopcock. Sample collection was begun with the start of the rinse which was considered zero time. The duration of the rinse was one to two seconds. Interrupted samples timed by a metronome were taken from the femoral artery at one second intervals using an 18 cm. length of polyethylene tubing (3 mm. internal diameter 2035

No abstract

In a prospective study we evaluated patients with diagnoses of (1) inguinal hernia (n = 57), (2) gall bladder stones (n = 80), and (3) carcinoma of the colon (n = 76). The whole group included 213 patients who underwent clean, clean-contaminated or contaminated operations. All wound infections and postoperative bacterial infections such as pneumonia or urinary infection, were recorded. The patients were asked for risk factors at the time of hospitalization: 7.1% of all patients admitted an intake of alcohol of more than 60 g/day, and 15.6% of the patients smoked more than 20 cigarettes/day. We found a four times higher risk of postoperative infection for patients with an intake of more than 60 g alcohol/day. The rate of infection for smokers of more than 20 cigarettes/day is twice as high as for non-smokers or persons who smoke fewer than 20 cigarettes/day.

No abstract