Nongenital warts: classification and treatment options.

Common, plantar and flat warts are the primary classes of nongenital warts. Although spontaneous remission does occur, all warts should be treated to avoid spreading. Common warts often develop in the periungual region of the fingers. This type of wart generally can be removed with cryotherapy, topical application of salicylic acid or occlusive taping. Plantar warts are found over pressure points of the heel or metatarsal heads. They are also treated with cryotherapy or salicylic acid. Flat warts are commonly seen on the dorsum of the hands or on the face. These warts are best treated with topical retinoids. Immunotherapies are being developed.

The results of Ramstedt's operation in a district general hospital.

From 1970 to 1979 78 pyloromyotomies were performed for congenital hypertrophic pyloric stenosis in the Royal United Hospital in Bath. Fourteen surgeons were involved. Fifty-eight operations were performed using local anaesthesia, and in this group a significantly smaller number of infants vomited postoperatively compared with those given general anaesthesia. There were no deaths, but a relatively high proportion of complications were encountered. These complications were related to the infrequent performance of the operation by the surgeons concerned rather than to the choice of anaesthetic. Pyloromyotomy should be carried out by surgeons with a special interest in the condition. Local anaesthesia offers an advantages by limiting postoperative vomiting.

Specific binding of human chorionic gonadotropin to human corpora lutea in the menstrual cycle.

Luteal tissue from 26 premenopausal women undergoing surgery for nonendocrine disease was examined for specific binding to human chorionic gonadotropin. Results showed a nadir in the percentage of binding on day 10, with a gradual increase until maximal binding was obtained on days 22 through 26. Binding then markedly declined to that seen on day 1 of the menses and decreased gradually to its lowest level on day 10.

Anovulation with estrogen production: receptor disorders?

Receptor antibodies have been implicated in the pathogenesis of several autoimmune disorders such as Graves disease. The authors hypothesized that serum antibodies against the luteinizing hormone (LH) receptor existed in women with chronic anovulation syndrome and continuously stimulated the ovaries. Twenty patients with the clinical diagnosis of anovulation with estrogen production were studied. The effects of serum globulins on the binding of 125I-labeled human chorionic gonadotropin (hCG) to ovarian receptors in the patients were compared with the effects in age-matched controls. These studies did not demonstrate significant inhibition of 125I-hCG binding to ovarian receptors by immunoglobulins of patients with anovulation and estrogen production in comparison with those of control subjects. This finding suggests that the cause of anovulation with estrogen production is not an autoimmune phenomenon involving the LH receptor of the human ovary.

Restorative surgery of the rectum with a circumferential stapler.

The results of rectal anastomoses produced with a circumferential stapling gun were compared with those of a conventional hand suturing technique in thirty patients undergoing colorectal anastomoses for carcinoma and diverticulitis. The main advantage of the stapler is in anastomoses low in the pelvis where it allows relatively easy access to the extra-peritoneal fraction of the rectum. When the stapling gun was used the mean distance of the anastomosis from the anal margin was less and the length of postoperative hospital stay was reduced. The incidence of complications associated with the anastomosis was similar for conventional suturing and stapling.