The usefulness of conducting investigations on intra-abdominal bacterial contamination in digestive tract operations.

A bacteriological study of 108 cases of gastrointestinal surgery was conducted by analyzing intra-abdominal bacterial contamination (IABC) and postoperative surgical site infections (SSI). We utilized an anaerobic porter to detect intra-abdominal bacterial infection and transport bacteria to the laboratory. The positive IABC rate was 42.9% for gastric cancer surgery, 22.6% for biliary tract surgery, and 85.7% for colorectal cancer surgery. Most cases of SSI were IABC-positive, and isolated bacterial species from the SSI were similar to those from the IABC. In colorectal cancer surgery, a preoperative chemical intestinal preparation and the prophylactic use of antibiotics had a major influence on the sensitivity of bacteria isolated from the SSI. These data suggest that prophylactic antibiotics should be chosen from among those to which bacteria from the IABC are highly sensitive, and that therapeutic antibiotics should be chosen from among those to which bacteria isolated from the SSI are highly sensitive. Finally, the exploration of IABC enables us to predict the incidence of SSI.

Late rectal complication following high dose rate intracavitary brachytherapy in cancer of the cervix.

PURPOSE: To examine the incidence of radiation-induced late rectal complications using a rectal reference point in patients with cancer of the uterine cervix. METHODS AND MATERIALS: The subjects were 253 patients with cancer of the cervix who underwent high dose rate intracavitary brachytherapy (HDR-ICR). The rectal point (RP) was defined according to the criteria recommended in the ICRU Report 38. The time-dose factor (TDF) and the biologically effective dose (BED) were calculated as components of the cumulative reference rectal dose using the rectal reference point dose in intracavitary brachytherapy combined with the external whole pelvis dose. RESULTS: Statistical comparison of factors affecting the incidence of late rectal complication was conducted using data for 161 patients. The incidence of late rectal complications in the 161 patients was 9 patients (5.6%) for grade 1, 51 patients (31.7%) for grade 2, 11 patients (6.8%) for grade 3, and 13 patients (8.1%) for grade 4. The TDF and BED values were significantly correlated with the incidence of late rectal complication, and also showed strong correlation (r = 0.976) with each other. Grade 4 rectal complication was not observed in any patients with TDF below 130 or BED below 147. The calculated incidence of complications ranged from 5 to 10% at TDF values from 104 to 124 and at BED values from 119 to 146. CONCLUSION: These data regarding the incidence of rectal complication may be useful in reducing the incidence of late rectal complications arising after HDR-ICR treatment of cervical uterine cancer by adjusting the dose per fraction and number of fractions of HDR-ICR in individual patients and by improving the technique of inserting the intracavitary radiation apparatus.

[High-resolution teleradiology system based on ISDN and small computer].

A high-speed, high-resolution teleradiology system based on the Integrated Services Digital Network (ISDN) is described. The LAN at Saku Central Hospital and the Radiological Department at Shinshu University Hospital (60 km) are interfaced to a Macintosh computer with an image digitizer, interactive display, and network interface. The transmission time for a digitized high-resolution radiographic image with 4.39 megabytes was 358 seconds using a 128 kbps (kilobit-per-second) channel (B1 + B2), and the mean transmission rate was 98.1 kbps. Teleradiology conference is also available using this system. Radiologists can observe the same high-resolution images on the CRT screen simultaneously at two different remote hospitals, indicating a point of interest on the image by means of a mouse cursor. Graphical data of interest to the radiologists are also transmitted and displayed on the CRT.