BackgroundPreoperative mechanical bowel preparation can be questioned as standard procedure in colon surgery, based on the result from several randomised trials.MethodsAs part of a large multicenter trial, 105 patients planned for elective colon surgery for cancer, adenoma, or diverticulitis in three hospitals were asked to complete a questionnaire regarding perceived health including experience with bowel preparation. There were 39 questions, each having 3 – 10 answer alternatives, dealing with food intake, pain, discomfort, nausea/vomiting, gas distension, anxiety, tiredness, need of assistance with bowel preparation, and willingness to undergo the procedure again if necessary.Results60 patients received mechanical bowel preparation (MBP) and 45 patients did not (No-MBP). In the MBP group 52% needed assistance with bowel preparation and 30% would consider undergoing the same preoperative procedure again. In the No-MBP group 65 % of the patients were positive to no bowel preparation. There was no significant difference between the two groups with respect to postoperative pain and nausea. On Day 4 (but not on Days 1 and 7 postoperatively) patients in the No-MBP group perceived more discomfort than patients in the MBP group, p = 0.02. Time to intake of fluid and solid food did not differ between the two groups. Bowel emptying occurred significantly earlier in the No-MBP group than in the MBP group, p = 0.03.ConclusionMechanical bowel preparation is distressing for the patient and associated with a prolonged time to first bowel emptying.

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All men born in even-numbered months in 1914 and domiciled in Malmö were invited in 1969 to participate in an investigation regarding risk factors for cardiovascular disease. Individuals with a blood pressure of 165/110 and over were treated and a sub-sample of heavy smokers were later invited to take part in a quit-smoking project. During the following five year period total and cause-specific mortality in the examined group was compared with corresponding data for men born in uneven months in 1914. Mortality in the examined cohort was lower than among controls and differed significantly from that in the control group with regard to cardiovascular mortality.

Staphylococcus aureus, strain Cowan I, contains a cell-wall substance, protein A, which combines with the Fc part of IgG in most mammalian species. It can therefore be used as a solid-phase immunoabsorbant for elimination of the reacting immunoglobulins. Since it has been shown that Cowan I could absorb out the blocking activity of sera from rats bearing isografts of polyoma-virus-induced sarcomas or chemically induced colon carcinomas, we investigated what effects Cowan I absorption of human tumor-bearer sera might have. In all tumor-bearer sera tested, from patients with melanomas or colon carcinomas, treatment with protein-A-containing staphylococci decreased the sera's ability to inhibit lymphocyte-mediated cytotoxicity in vitro. Cowan-I-treated sera from healthy controls had no effect on lymphocyte cytotoxicity. Nor did Cowan-I-treated tumor-bearer sera potentiate or "arm" normal lymphocytes against tumor target cells. There was no evidence of complement-dependent cytotoxicity with added human complement in sera from melanoma and colon carcinoma bearing patients either before or after absorption with Staphylococcus aureus, Cowan I, The concentrations of IgA, IgG and IgM were determined in sera used for in vitro tests of blocking activity and complement-dependent cytotoxicity before and after absorption. No reduction of IgA, reduction to undetectable levels of IgG and 20-30 percent reduction of IgM immunoglobulins as compared to unabsorbed sera were demonstrated.

Small bowel ischaemia causing necrosis is a rare complication after aorto-iliac reconstructive surgery. During a 14-year-period we have seen 6 cases out of 1343 reconstructions, making a frequency of 0.4 per cent. Diagnosis was difficult, causing a delay until re-exploration. Thrombocytopenia was a constant finding, and should raise suspicion. Pathogenesis was multifactorial. In two of our cases diagnosis was made at autopsy and in four at operation. Two patients survived extensive bowel resection but had a long stormy postoperative course.

In vitro assays of cell-mediated tumor immunity utilizing 51Chromium (51Cr) labelling of cultured adherent solid tumor cells were designed which allowed an effector cell/target cell incubation time of 48 h without overriding spontaneous 51Cr release. In a series of 16 consecutive experiments, blood lymphocytes from healthy human donors, from patients with tumors unrelated to the cultural tumor target cells, and from colon carcinoma and melanoma patients were tested for their cytotoxic effects on various target cell pairs, human colon carcinoma, melanoma, or skin fibroblasts. The same reagents were used in simultaneously performed microplate and 51Cr assays. Results obtained by visual counting of microplate tests and by 24-h assays of 51Cr release or 51Cr retention correlated in 20/25 effector-cell/target-cell combinations. In a series of six consecutive experiments, lymph-node cells from untreated Wistar/Furth rats, and rats bearing either chemically-induced colon carcinoma NG-W1 or polyoma virus-induced sarcoma P-W13 were tested for their cytotoxicity on syngeneic rat colon carcinoma and sarcoma target cells. Criss-cross type experiments were performed by microplate and 15Cr techniques done in parallel. Results obtained by visual counting of microplate tests and by 48 h assays of 51Cr release or 51Cr retention correlated in 15/18 effector-cell/target-cell combinations.

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In 1969 a cohort of 703 men born in 1914 was screened to determine the prevalence of cardivascular and pulmonary diseases among middle-aged men. Smoking habits and other cardiovascular risk factors were registered. Hypertension was treated. The disability pension rate among non-smokers was considerably lower than that for smokers. Also the proportion of individuals who had been admitted to hospital and the proportion of individuals who had reported sick was lower in non-smokers than in smokers. The ex-smokers showed an intermediate position both in terms of disability pension rate and in proportion of individuals admitted to hospital. High systolic blood pressure, high cholesterol level and high triglyceride values in 1969 were not associated with increased disability pension rate, hospitalization rate or with increased sick leave.