Association of ploidy and cell proliferation, Dukes' classification, and histopathological differentiation in adenocarcinomas of colon and rectum.

OBJECTIVES: To find out if there is an association between DNA indexes and DNA synthesis (S) phase measurements and Dukes' classification and histopathological differentiation in colorectal cancers, and to investigate the interrelationship between DNA indexes and S phase measurements. DESIGN: Prospective open study. MATERIAL: 182 colorectal carcinomas in 181 consecutive patients. INTERVENTION: Tumours biopsied immediately after resection or at rectoscopy or colonoscopy. RESULTS: One or more aneuploid cell populations were found in 113 of 182 carcinomas (62%). There was no correlation between Dukes' stage and either degree of differentiation or S phase measurements, but there were significant correlations between S phase measurements and histological grading (p less than 0.05), and between the percentage of cells in the S phase and the DNA index when values for both diploid and aneuploid tumours were included (p less than 0.001). CONCLUSION: The degree of aneuploidy indicates how far tumour cells have progressed in their cellular disarrangement, and information about a tumour's proliferative capacity is given by the S phase measurements.

Urethral strictures following transurethral resection of the prostate. The role of the catheter.

Urethral stricture is the most common late complication of transurethral prostatectomy (TURP). The cause is unknown. A prospective, randomised study was undertaken to investigate the role of the transurethral catheter in stricture formation. A total of 205 patients subjected to TURP were studied. Following resection, they were randomly divided into 2 groups: those drained by a transurethral siliconised latex catheter and those drained by a suprapubic siliconised latex catheter. At follow-up, 6 to 24 months later, 17% of the patients in the transurethral group had developed urethral stricture; the corresponding figure in the suprapubic group was 4%. As a consequence of the higher incidence of stricture in the transurethrally drained group, more patients in that group were dissatisfied with the results of the operation. It was concluded that the post-operative transurethral catheter was an important factor in stricture formation following TURP and that transurethral drainage with a siliconised latex catheter resulted in a higher incidence of stricture. This led to a greater number of patients being dissatisfied with the results of the operation, but the catheter did not affect the results in any other way.

Ideal cholecystectomy: in an early stage at an early age.

Two consecutive series of patients operated for gallstone disease were compared. One series emanated from a Swedish hospital in which an active surgical policy had been practised for many years while the other stemmed from a Swedish hospital in which the attitude towards surgery had been conservative. In this latter hospital there were more cases with biliary duct stones, especially hepatic duct stones. There were also more cases with jaundice, more cases with acute cholecystitis with high fever, more cases with protracted postoperative fever and with infection of the wound and more cases with a lengthy stay at the hospital. Responsible for all these differences were the older age groups. The conclusion is that the ideal treatment for gallstone disease is early operation, i.e. operation in an early stage and at an early age.

Fractures of the tibial shaft after skiing and other accidents.

Fractures of the tibial shaft from skiing accidents were compared with fractures of other etiology. Skiing fractures more often affected the lower third of the tibia and they seldom were open. Many were comminuted or transverse but displacement tended to be slight. The incidence of complications was low and the periods of hospitalization, of healing, and of inability to work were shorter than for the other fractures. The highly favorable prognosis was evident whatever the method used for treatment. Methods of treatment of tibial fractures should not be compared on the basis of experience with skiing fractures, because of the exceedingly favorable prognosis of the latter.