18 Sultan AH, Kamm MA, Hudson CN, Bartram CI. Anal sphincter disruption in 32% of vaginal deliveries: prospective ultrasound study. Gur 1992; 1: S66. 19 Parks AG. Post-anal perineorrhaphy for rectal prolapse. Proc R Soc Med 1967; 60: 44-5. 20 Neil1 ME, Parks AG, Swash M. Physiological studies of the anal sphincter musculature in faecal incontinence and rectal prolapse. 21 Henry MM, Parks AG, Swash M. The pelvic floor musculature in the descending perineum syndrome. Er J Surg 1982; 69: 470-2. 22 Rogers J. Laurberg S, Misiewicz JJ, Henry MM, Swash M. Br J Surg 1981; 68: 531-6. Anorectal physiology validated: a repeatability study of the motor and sensory tests of anorectal function. Er JSurg 1989; 7 6 607-9. 23 Farthing MJG, Lennard-Jones JE. Sensibility of the rectum to distension and the anorectal distension reflex in ulcerative colitis. 24 Roe AM, Bartolo DCC, Mortensen NJMcC. New method for assessment of anal sensation in various anorectal disorders. Br J 25 Laurberg S, Swash M, Henry MM. E5ect of postanal repair on progress of neurogenic damage to the pelvic floor. Er J Surg 1990,Endoscopic staplers have been developed primarily for use in laparoscopic surgery, but an alternative application of such an instrument is reported.
Implantation of autologous splenic tissue was performed in 2 patients after splenectomy for trauma. In order to demonstrate some function of the implanted splenic tissue, spleen scintigraphy, using 99Tcm‐labelled heat‐damaged autologous erythrocytes, and measurement of the percentage of circulating vacuolated erythrocytes were carried out 1 and 3 months after splenectomy. The spleen scans were positive after 1 month and the isotope uptake increased after 3 months, demonstrating splenic phagocytic function. The number of vacuolated erythrocytes also indicated some restoration of the pitting function of the implanted splenic tissue. No alterations in serum immunoglobulins were seen, but a moderate thrombocytosis and monocytosis persisted for 3 months. Future improvements in the implantation procedure are discussed.
In five pigs weighing approximately 85 kg. the pelvic pressure-volume relationship was investigated. Through a catheter introduced into the renal pelvis from the ureter with ligation at the ureteropelvic junction, a continuous filling of one ml./minute was established. After drainage of the pelvis filling was begun showing an exponential relationship between pressure and volume. Fillings in all of the units confined the equation y = a + bx + cx2. Emptying showed unanimously clockwise hysteresis although 1/3 of the fillings revealed active contractile forces with an inverted S-shaped emptying curve. The normal multicalyceal renal pelvis in pigs of the same size showed a wide range of pressure-volume relationships both between individuals and between the two investigations. This wide range might be of importance in the development of dilatations due to obstruction.
The protective effect of splenic implantation or hemisplenectomy on the survival rate was studied in 34 Wistar rats inoculated intravenously with 8.5 × 106 CFU Streptococcus pneumoniae type 25. 4 months prior to the bacterial challenge, different surgical procedures were performed, dividing the animals into 5 equally large groups: (1) sham operation, (2) hemisplenectomy, (3) splenectomy with a 100% reimplantation, (4) splenectomy with a 50% reimplantation, and (5) splenectomy without reimplantation. The observation period after the bacterial inoculation was 13 d. Differences in mean survival rates were found: (1) 13 d, (2) 10.6 d, (3) 7.1 d, (4) 5.6 d, and (5) 3.1 d. The increasing survival rates correlated with increasing weights of the residual splenic tissue. This animal study indicates that residual splenic tissue may account for a lesser tendency to infection.
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