Laparoscopic incisional hernia repair with a self-centring suture.

BACKGROUND: Open incisional hernia repair is associated with high morbidity and recurrence rates. Laparoscopic approaches offer improved long-term results with low complication rates. METHODS: Laparoscopic repair was attempted in 117 consecutive patients (median age 68 (range 31-91) years, 50 men) undergoing 122 operations. A novel mesh centralization technique was employed. Data were recorded prospectively. Follow-up was by clinical review or telephone consultation. RESULTS: One hundred and eighteen procedures (96.7 per cent) were completed laparoscopically; four required conversion. Forty-one patients (35.0 per cent) had additional, unsuspected defects. The median mesh size was 225 (range 42-600) cm2. Median follow-up was 42 months. Small bowel enterotomy occurred in six patients. Fourteen postoperative seromas were successfully aspirated. Recurrence was detected in nine patients (7.7 per cent). One patient was readmitted with small bowel obstruction that settled with conservative management. There were no enterocutaneous fistulas. One patient died after operation from myocardial infarction. CONCLUSION: Laparoscopic incisional hernia repair using a self-centring suture provides good long-term results with low complication rates.

Pyruvate kinase deficiency anaemia in a Basenji dog.

Pyruvate kinase deficiency anaemia was suspected in an 18-month-old male Basenji dog after other known causes of canine haemolytic anaemia had been excluded. Anaemia of moderate severity (packed cell volumes 0.20 to 0.26 1/1) and reticulocytosis (uncorrected reticulocyte counts 8 to 43%) persisted during 5 months' observation, and biopsies showed development of bone marrow fibrosis and sclerosis. The diagnosis of pyruvate kinase deficiency anaemia was presumptive because erythrocyte pyruvate kinase concentrations in the affected dog were inconclusive and related animals were not available for enzyme assay. However, the gene for pyruvate kinase deficiency is known to occur among Basenji dogs in Australia.

Warm- and fatigue in skill acquisition and performance.

Two experiments examined the effects of preliminary exercise on performance and learning of the Fitts' reciprocal tapping task. In the first experiment preliminary exercise was performed with either the preferred or nonpreferred arm. The tapping task was completed with the preferred by both groups. Low levels of preliminary exercise resulted in heightened performance for both groups, but higher levels resulted in a decrement for the group using the preferred arm. An arousal-plus-fatigue hypothesis can explain the results. A subsequent post-test without preliminary exercise showed no difference between the groups, indicating an effect on performance and not learning. In the second experiment preliminary exercise was provided by treadmill running to exhaustion. Again, a facilitatory effect of exercise was demonstrated on tapping performance even after exhaustive levels of running.

Hemoglobin values: comparative survey of the 1976 Canadian Olympic team.

In view of the role of hemoglobin in oxygen transport, the hemoglobin concentration in whole blood may indicate readiness for maximal physical performance. Hemoglobin concentrations were determined in members of the 1976 Canadian Olympic team and compared with those of the 1975 Canadian general population and with published data for the 1968 Australian and Dutch Olympic teams. The mean hemoglobin concentrations of the 123 male and 64 female Canadian Olympic athletes were 14.7 +/- 1.0 and 12.9 +/- 0.7 g/dL, respectively. Both male and female Canadian Olympic athletes had significantly lower (P less than 0.01) values than the other three groups. The suboptimal hemoglobin concentrations may be related to inadequate dietary intake of protein and iron.