Hepatic connective tissue changes after surgical treatment of portal hypertension

The study was done on twenty patients, they were classified into two groups: One group with no evidence of liver disease or portal hypertension, the other group was admitted for surgical treatment of esophageal varices and portal hypertension [elective splenectomy and devascularization]. Blood samples were collected from both groups pre- and postoperatively and were divided into 3 parts: A part for routine investigations, another for detection of serum procollagen III and the third part for estimation of plasma fibronectin by radioimmunoassay. Liver biopsy was taken for histopathological examination and estimation of total collagen

Fat emulsion adversely affects lymphocyte reactivity

This study examined the effects of five parenteral nutrition solutions on in vitro lymphocyte reactivity and measured lymphocyte responsiveness in patients receiving parenteral nutrition. Normal human lymphocytes were incubated with dilutions of: a] an amino acid/ dextrose solution, b] an amino acid-dextrose/fat solution, c] an amino acid solution, d] dextrose, and e] a fat emulsion and lymphocyte responsiveness to antigenic [PPD] and mitogenic [PHA] stimulation was measured. Lymphocyte reactivity was significantly depressed in patients during infusion of the fat emulsion impairs lymphocyte reactivity and suggest that careful consideration should be given using fat emulsion in patients in whom cell-mediated immunity is impaired already

Enhancement of neurophil chemiluminescence after elective gastrointestinal surgery

The aim of the study was to test the hypothesis that elective surgery as a form of injury has no prolonged deleterious effect on neutrophil activity in nonseptic patients. In the first 9 days after elective gastrointestinal surgery, a biphasic neutrophilia occurs and the metabolic response of neutrophils to an opsonized particle is not impaired. Major elective surgery has no deleterious effects on neutrophil activity, and indeed neutrophil activity may be enhanced

One-Stage bilateral inguinal hernia repair

There is still much controversy about the timing of bilateral inguinal hernia repair. This study determined recurrence and complication rates of unilateral versus bilateral repair. Of 200 patients included in this study, 100 underwent unilateral repair and 100 had one-stage bilateral repair. Results suggested that one-stage bilateral inguinal hernia repair does not result in increased rates of most postoperative complications or recurrence when compared with unilateral repair

Management of diffuse peritonitis by prolonged postoperative peritoneal lavage

Prolonged postoperative peritoneal lavage has been used as a part of the management of 55 patients with diffuse peritonitis. The lavage technique consisted of 60 min cycles of instillation and drainage of a lavage fluid into the peritoneal cavity via a peritoneal dialysis catheter. The lavage fluid was slightly salt solution containing antibiotics, usually cefotaxime and metronidazole. The overall mortality rate in the series was 11% [6/55]. Only one of these patients had residual abdominal sepsis present at postmortem the remaining deaths being due to a progression of the preexisting disease. Five patients showed evidence of further intraabdominal sepsis. In three of these patients, this was associated with the presence of a previously well established abscess cavity. The overall results indicate that for this group of patients recognized to be high risk of mortality or further sepsis, the use of prolonged postoperative peritoneal lavage is associated with an improved outcome