Central institutional ethics committee needed to facilitate timely review of multicenter clinical trials.

A multicenter trial in India undergoes review by Institutional Ethics Committees (IECs) of all participating institutions. The failure to obtain approval even from a single institution's IEC creates a situation of inequitable access to clinical trials. The dichotomy in decisions of different IECs is attributed to lack of standardization and accountability in their functioning. The registration of IECs with Central Drugs Standard Control Organization notwithstanding, the current model of IEC review has failed to ensure uniformity in IEC decisions in multicenter trials. Alternative models that allow central review of multicenter clinical trials should be explored.

Ulnar artery as a coronary bypass graft.

BACKGROUND: The ulnar artery has been used as a coronary bypass graft in 8 patients when it was deemed unsafe to harvest the radial artery after evaluation of the arterial circulation in the forearm and hand. METHODS: The ulnar artery was removed from the lower three quarters of the forearm, along with its satellite veins. Dissection was commenced distally near the wrist and extended proximally to where the ulnar artery passed between the two heads of origin of the flexor digitorum superficialis. The artery was divided distally above the wrist joint and proximally at a point immediately below the origin of the common interosseus artery. RESULTS: Ten ulnar arteries were removed for use as coronary artery bypass grafts; two were rejected, one because of severe calcification and the other because of atherosclerotic occlusion. The remaining eight ulnar arteries were grafted successfully to coronary arteries other than the left anterior descending. No early hand or cardiac complications were observed. CONCLUSIONS: The ulnar artery is an alternative coronary artery bypass graft that may be used when the radial artery is dominant and cannot be removed without risk. The ulnar artery is in close proximity to the ulnar nerve and harvesting has the potential to injure the nerve. Therefore, until the use of the ulnar artery has been more fully evaluated it should be used only when other options have been exhausted.

Port-site recurrence after thoracoscopic resection of oesophageal cancer.

We report a case of thoracoscopic port-site recurrence after a thoracoscopically assisted total oesophagectomy for squamous cell carcinoma. The tumour was not extracted through the port site.

Involvement of a circadian rhythm in the photoperiodic ovarian response of the yellow-throated sparrow, Gymnorhis xanthocollis.

Groups of the photosensitive female yellow-throated sparrow were placed under various light-dark cycles, in which a fixed ultrashort photophase of 3 h was combined with dark phases of varying duration, resulting in cycles of 18-30 h. Simultaneously, two groups of birds, one in short days (8L/16D) and the other in long days (15L/9D), were kept as controls. Significant ovarian growth, observed at 30 and 60 days, was induced by 3 h ultrashort photophase only if it was introduced in the cycles of 18 h (3L/15D), 20 h (3L/17D), 26 h (3L/23D), 28 h (3L/25D) and 30 h (3L/27D) as well as under long days (15L/9D), whereas there was no response to the ultrashort photophase in cycles of 22 h (3L/19D) and 24 h (3L/21D) and in short days (8L/16D). It seems that there is an ovarian response to the ultrashort day cycles when a phase advance or delay of photosensitivity of the response system repeatedly produces coincidence of the external photophase (3 h) with the photosensitive phase of an endogenous circadian rhythm. The results are thus consistent with the Bünning hypothesis, which suggests the involvement of an endogenous circadian rhythm in photoperiodic time measurement.

Photoperiodic ovarian response in yellow-throated sparrow, Gymnorhis xanthocollis: involvement of circadian rhythm.

The experiments aim to investigate the mechanism of photoperiodic time measurement during photoperiodic ovarian response of subtropical yellow-throated sparrow. Groups of the photosensitive female birds were exposed to various night-interruption cycles for a period of 35 days. These light-dark cycles consisted of a basic photophase of 6h and 1h photointerruption of the 18h dark phase in 24h cycle at different points. A control group was also placed under 7L/17D. Ovarian response was observed in the night-interruption cycles in which the photointerruption of dark phase was made 12h after the onset of basic photophase. The results are consistent with the Bünning hypothesis and indicate that an endogenous circadian rhythm is involved in photoperiodic time measurement during initiation of ovarian growth in this species.