There is a relationship between chronic renal damage and renal function at the time of biopsy. Since the quantification of interstitial lesions with morphometric techniques is very time consuming, a fully automatic method to quantify chronic damage is desirable. Progression of chronic renal damage could be viewed as a texture modification of tubulointerstitial structures. The aim of the present work is to study whether chronic renal damage could be automatically measured by means of texture analysis based on mathematical morphology. Among the morphological tools the best suited for our purpose is that of granulometry. Between four and six fields from 35 renal biopsies with different degrees of renal damage were stained with Sirius red and digitized under polarized light. In each field granulometric function with a circular structuring element was obtained. Interstitial volume fraction was measured with a point counting technique. Glomerular filtration rate at the time of biopsy was available in each case. A positive relationship between granulometric function and glomerular filtration rate was observed (r2 = 0.85). The determination coefficient between interstitial volume fraction and renal function was (r2 = 0.54). In conclusion, we describe a fully automatic method that precisely quantifies interstitial chronic renal damage.

SummaryA randomised double-blind comparison of oral famotidine and ranitidine given 2 hours before induction, on gastric secretion (volume and p H ) was carried out on 93 patients undergoing elective surgery. Gastric contents were aspirated immediately after tracheal intubation. Famotidine significantly reduced the gastric volume, compared with the other groups, including ranitidine. Both famotidine and ranitidine significantly elevated gastric p H towards neutral, compared with the other groups. There was no significant difference between ranitidine and famotidine in respect of the p H . The patients prernedicated with farnotidine and ranitidine were well protected against Mendelson's syndrome, whereas 38% of patients from the other groups remained at risk.

A case report is presented of a woman with known myotonia dystrophica, who required partial gastric resection and cholecystectomy. Neuromuscular blockade was obtained using a single dose of vecuronium, and neuromuscular function was determined by the "train-of-four count" technique. The intraoperative course was uneventful, and it was not necessary to use neostigmine to antagonize neuromuscular blockade at the end of the operation. There were no postoperative complications and the patient was discharged from hospital 10 days later.