Multi-nuclear magnetic resonance study of Na3AlF6-AlPO4 molten and solidified mixtures.

Phosphorus is one of the predominant impurities in the Hall-Heroult process for industrial aluminium production. The nature of the dissolved phosphorus species in the Na(3)AlF(6)-AlPO(4) system has been investigated by in situ high-temperature (HT) (19)F, (23)Na, (27)Al, (17)O, and (31)P NMR. The combination of these experiments enables to define the presence of PO(4)(3-), AlF(5)(2-) and (AlF(4)-O-PO(3))(4-) anions in the melt, and then the formation of Al-O-P bonding. Melts solidified at different cooling rates were characterised using various solid-state NMR techniques including multiple quantum magic angle spinning (MQMAS), rotational echo double resonance (REDOR) and heteronuclear single quantum correlation (HSQC). The glass obtained by the rapid quenching of the hypereutectic melt has been carefully described in order to better understand the structure of the melt.

[Open readmission. A service to patients with incurable cancer]. / Apen retur. Et tilbud til pasienter med uhelbredelig kreftsykdom.

The Open readmission programme is a service to patients with incurable cancer. It allows the patients and their family to contact our department at any time if medical assistance is needed. Each patient is allocated a primary nurse who has the main responsibility for his on her particular case. The nurse has been delegated the responsibility to evaluate the need for admission to hospital, and to arrange it. If acute hospitalization is needed a nurse at the department is contacted and an ambulance is sent. The patient is admitted without any primary examination by an emergency service unit or a practising physician. The patients are not delayed in the emergency room, but are directly transferred to a clinical ward. The nurses are responsible for administering the programme, and the physician notes the admission in the medical records. The Open readmission programme has been a success in the way it has been practised at our department, and meets the needs of patients and relatives for greater security and confidence that they will receive help.

[Eosinophilic gastroenteritis]. / Eosinofil gastroenteritt.

We describe the case of a 33 year-old woman who was hospitalized for ascites, abdominal pain and food allergy. Blood samples and histologic examination of a jejunal specimen removed by laparotomy revealed that the patient suffered from eosinophilic gastroenteritis. This disease is classified among the hypereosinophilic syndromes, and food allergy may be of etiologic importance. Clinically eosinophilic gastroenteritis may present with ascites, malabsorption or gut obstruction. The eosinophilic blood cell count is usually elevated and the erythrocyte sedimentation rate is usually normal or slightly increased. Polyarteritis nodosa, Crohn's disease and nematodal infections of the gut must be excluded. Most patients respond well to corticosteroid therapy and the long-term prognosis is good, even though the disease is chronic in nature.

[Self-regulated intake of food and drinks after abdominal surgery]. / Selvbestemt inntak av mat og drikke etter abdominaloperasjoner.

106 consecutive patients who had undergone laparotomy were allowed to drink freely from the first and to eat from the second day after operation. Only patients with an operated oesophagus were excluded. Nasogastric suction was not used. Our study shows that if patients are allowed to choose, they like to drink and to eat soon after the operation. They prefer water, juice and soup during the early days. Most of them soon drank more than 1,500 ml of liquids per day. They often start to drink and to eat before the passage of first flatus. Only five patients (4.7%) needed to have a nasogastric tube inserted. We found no major complications associated with our regimen. All our patients are now allowed to drink and eat according to their own wishes.

[Pelvi-rectal abscesses. Diagnosis, treatment and follow-up by transrectal ultrasonography]. / Pelvirektale abscesser. Diagnostikk, behandling og oppfølging ved hjelp av transrektal ultralydundersøkelse.

Pelvirectal abscess usually presents with vague symptoms which may delay diagnosis and subsequent treatment. However, it is important to recognize this condition since these abscesses may interfere with the sphincter function or give rise to chronic fistulo-in-ano. We describe two patients in whom transrectal ultrasound was applied for diagnosis, and who were treated for a pelvirectal abscess. Both patients were admitted to our hospital because of tumour of the rectum. There were few symptoms and signs of infection. Transrectal ultrasound examination of the rectum made a significant contribution to early diagnosis. We also point out the advantage of transrectal ultrasound examination during follow-up, mainly because we were able to rule out malignant neoplasm by obtaining an ultrasound-guided specimen for histological examination.

[Rectal cancer. Staging with transrectal ultrasonography]. / Cancer recti. Vurdering av dybdevekst med transrektal ultrasonografi.

30 patients with carcinoma of the rectum were examined preoperatively with endoluminal rectal ultrasound and digital examination in order to assess the stage of the tumour. The results were compared with the histopathological findings in the resected specimens from 23 patients. The following operations were performed: 11 abdominoperineal rectal amputations, five low anterior resections and seven local excisions. Discrepancies between the ultrasonic and histological staging occurred in seven patients, six tumours were overstaged and one understaged ultrasonically. Digital assessment overstaged eight tumours and understaged two. The ultrasonic examination provided additional information in 12 patients.

[Intraoperative ultrasonography of the liver]. / Intraoperativ ultralydundersøkelse av lever.

Intraoperative ultrasound is the most recent diagnostic tool in liver surgery. It presents the surgeon with a technique that can provide detailed information about liver tumours and their topography prior to surgery. It also provides very good visualization of the vascular tree of the liver. This article gives a detailed description of the technique of intraoperative ultrasound of the liver. It also presents results from two groups of patients: 30 patients who underwent laparatomy for colorectal cancer (n = 16) or for liver tumours (n = 14) were examined by intraoperative ultrasound of the liver. The results were compared with the observations made by preoperative ultrasound examination. In seven patients the intraoperative ultrasound examination showed liver tumors that had not been detected preoperatively. The intraoperative ultrasound was decisive for the operative strategy in three of the patients treated for liver tumours. In one of the patients operated on for colorectal cancer, in whom the intraoperative ultrasound examination revealed a previously unrecognized metastasis, a liver resection is now planned. Our study confirms that intraoperative ultrasound is a valuable form of examination in patients treated for colorectal cancer and is important for deciding the surgical strategy for patients treated for liver tumours.

[Surgical treatment of gastroesophageal reflux. Evaluated by manometry and 24-hour pH monitoring of the esophagus]. / Kirurgisk behandling av gastroøsofageal refluks. Vurdert med manometri og 24 timers pH-måling i oesophagus.

From 1980 to 1989, 46 patients underwent surgery for pathological gastro-oesophageal reflux disease; 28 with Nissen technique, nine with Hill technique and nine with a modified Belsey technique. 11 patients (24%) experienced postoperative complications, 21% after Nissen, 33% after Hill and 22% after Belsey. Two of six patients suffered recurrence of their reflux symptoms after Belsey, three of six after Hill and two of 26 (8%) after Nissen. 85% experienced no reflux symptoms after Nissen fundoplication. 17 patients suffered from flatulence, three were not able to belch and two were not able to vomit. Median lower oesophageal sphincter pressure before Nissen fundoplication was 6.0 mmHg and length was 2.0 cm. After the operation the pressure increased to 10.0 mmHg and the length to 3.0 cm. Four patients underwent ambulatory 24-h oesophageal pH monitoring both preoperatively and postoperatively. The preoperative registration was pathological in all patients, but in three patients the postoperative pH was normal.

[Severe hemorrhage in pancreatic pseudocyst]. / Alvorlig blødning ved pancreascyste.

Pseudocysts in the pancreas occur in 10% of patients with pancreatitis and may lead to serious complications, i.e. infection, obstruction of the bile duct, rupture, and hemorrhage. The last complication is highly lethal. Two patients are described, with differing modes of presentation and therapy. In one patient hemostasis was obtained by surgical packing followed by percutaneous embolization. In the other patient embolization failed and surgical resection was necessary.

[Distal esophageal banding. A modified method of surgical treatment of obesity]. / Distal oesophagusbanding. En modifisert metode til operativ behandling av adipositas.

64 patients were treated with distal oesophageal banding for morbid obesity from 30/4-1984 to 1/6-1988. By this method a Dacron vascular prosthesis is passed around the oesophagus from incisura cardiaca to pars cardiaca. There will be no upper ventricular pouch. The method was introduced in order to avoid the problems seen after operation with gastric banding, such as valve mechanism secondary to pouch distension and band penetration. Such problems have not been encountered following our operative modification. 18 patients were observed for more than two years. The mean weight loss one year after operation was 28 kg, which was equivalent to 26% of preoperative weight. The main problem is excessive tightening of the band. Therefore, in three patients, the band had to be removed later.