Seromuscular patch as an adjunct in reconstruction of the cervical esophagus with free jejunal transfer.

During cervical esophageal reconstruction, an auxiliary piece of seromuscular tissue can be developed based on the same vascular pedicle as the interpositional piece. This segment of vascularized tissue can be used as a reconstructive aid in compromised areas where wound problems may create disastrous complications (e.g., carotid rupture or tracheoesophageal fistula). The proximal bowel anastomosis can be reinforced, an exposed carotid can be covered, or the distal jejunal anastomosis can be circumferentially wrapped. Any skin deficiencies created by placement of the seromuscular sleeve are easily corrected by a split-thickness skin graft.

Personality characteristics of hospice volunteers as measured by Myers-Briggs Type Indicator.

A sample of hospice volunteers (n = 99) was administered the Myers-Briggs Type Indicator (Myers & McCaulley, 1985). Frequencies of types observed were compared to population sample (n = 1,105) frequencies. Results indicated that, as a whole, hospice volunteers preferred extraversion over introversion, intuition over sensing, and feeling over thinking. Analysis of four-and two-letter preference combinations also yielded statistically significant differences. Most notably, the sensing-intuitive function appeared pivotal in determining of hospice volunteering. Suggestions are offered as to why the sensing-intuition function appeared central to hospice volunteering. Results appeared consistent with Jungian personality theory.

Diagnostic laparoscopy for suspected appendicitis.

One hundred consecutive patients who underwent diagnostic laparoscopy for suspected appendicitis were evaluated to assess the appropriate clinical setting for laparoscopic appendectomy. The usefulness of diagnostic laparoscopy in the setting of acute abdominal pain has been well documented. However, there is debate about the use of laparoscopy for definitive therapy. The purpose of this study is to evaluate the decision making process during diagnostic laparoscopy for suspected appendicitis. When pathology is identified other than in the appendix, the majority of patients can be treated without converting to an open procedure. In patients found to have no obvious pathology, incidental appendectomy can be performed laparoscopically. When appendicitis was identified, the majority of patients could be treated safely without converting to an open technique. However, there were certain clinical situations that necessitated conversion to an open operation. Involvement of the cecum or perforation at the base of the appendix puts the appendiceal stump at risk for leak and abscess formation. Evaluation of the cecum by palpation for a mass should also be performed in this situation. Another situation in which conversion to an open technique is warranted is an appendiceal abscess with adherent small bowel. The friability of bowel wall greatly increases the risk for bowel injury in this setting. Laparoscopy is a useful technique for the diagnosis and treatment of abdominal pain even if the appendix is normal on inspection. Conversion to an open operation should be employed when inflammation or perforation occurs at the base of the appendix and when bowel is found to be adherent to an appendiceal abscess.

Effects of subliminally presented auditory suggestions of itching on scratching behavior.

This study investigated effects of masked verbal suggestions of itching, utilizing a design closely analogous to commercially available subliminal audiotapes. Students participated in 1 of 3 groups (n = 21): an experimental group listened to an audiotape with music masking suggestions of itching, Control Group 1 listened to an audiotape with music only, and Control Group 2 listened to suggestions of itching presented supraliminally. Dependent variables included both behavioral and self-report measures of itching. There was no evidence of influence from subliminal suggestion; however, results assessing the influence of supraliminally presented suggestions were mixed for self-report and behavioral measures.

Volunteers under threat: AIDS hospice volunteers compared to volunteers in a traditional hospice.

We studied volunteers in one of the world's first AIDS-dedicated hospices and compared them on demographic, experiential, and personality related dimensions to volunteers in a traditional hospice. Eighty percent of the active volunteers at each facility participated. Eight of 16 demographic and 4 of 11 personality related variables differentiated the two groups. AIDS hospice volunteers were on all measures a more heterogeneous group--largely gay or bisexual, younger, more likely to have had prior personal experience with AIDS. In addition, they perceived themselves to be functioning under a significantly higher degree of threat caused by their volunteer work. We performed a post hoc analysis controlling for sexual orientation and matching heterosexual volunteers for gender. Threats to health, social world, employment, and total threat significantly differentiated the two heterosexual groups of volunteers.