After curative resection for colorectal cancer, the LNR is an important prognostic factor and should be used in stratification schemes for future clinical trials investigating adjuvant treatments.

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The esophagus provides a diagnostic and therapeutic pathway not only for gastroenterologists but for surgeons, radiologists, cardiologists, and other specialists. Unfortunately, this procedural traffic occasionally leads to iatrogenic injury. As well, though reasonably well protected anatomically, frank esophageal injuries due to non-iatrogenic causes are not uncommon. We present a review of the literature on this subject covering anatomy, etiology, diagnostics, therapeutics, and management generally.

Ratios of lactulose/mannitol excretion in urine have been signed to assess perturbations of intestinal permeability I • used to assess the extent of intestinal permeability in after burn injury. Seven men with burns ranging from _ various disease and trauma conditions. Reported studies 31% to 78% of the total body surface area (mean 58%) have used this technique to correlate altered gastrointeswere used in this preliminary study to develop our assay (• tinal mucosal permeability totranslocation of bacteria and technique. On the fourth day after the burns were endotoxin, leading to occult sepsis in bum patients.sustained, the patients were given 5 g of mannitol and Enzymatic methods of analysis for urine concentrations of 10 g of lactulose in 100 mL of de-ionized water. A 6-h mannitol and lactulose were used in these studies. We urine collection was initiated after ingestion of the test have found that urine from patients with severe burns solution. We added 1 mL of a 200 g/L chlorhexidine frequently contains compounds that interfere with the solution to the total urine collected. Aliquots of the enzymatic methods. We describe using gas-liquid chrourine samples were frozen at -20 'C until analyses matography to determine mannitol and lactulose simultawere perfbrmed. neously in the urine of burn patients. To avoid the multiple Sample preparation: We added 125 AL of 1 mmoIIL peaks for the anomeric forms of the reducing sugars methylmannopyranoside reagent as an internal standuring precolumn trimethylsilyl derivatization, we condard to 50Al of fivefold-diluted (with de-ionized water) verted the sugars to oximes before the silylation step. The drd ThL of ved-iltedn(withnde ed wer) method gave good recoveries of mannitol and lactulose urine. The sample and internal standard were dried added to burn patients' urine samples. Unlike the enzyunder nitrogen in a heating block at 75 °C. Aftr these matic methods, gas-liquid chromatography eliminates the cooled, we added 100 ML of oxin' solution (25 mg of effect of interfering compounds and allows for the simulhydroxylamine hydrochloride per inilliliter of pyridine), taneous determination of both sugars in urine samples.capped the samples, and incubated them at 75 0C for 30 min. After letting the samples cool, we added 100 AL of Several investigators have proposed that thermal n-trimethylsilyl imidazole reagent (Pierce Chemical, injury alters gastrointestinal mucosal permeability, Rockford, IL 61105-9976) and incubated the solutions causing translocation of bacteria and endotoxin and for 15 min at 75 'C. leading to occult sepsis and multiple organ failure (1-3).Standard preparation: Stock solutions of mannitol (5 Ratios of lactulose/mannitol urine excretion have been mmol/L) and lactulose (0.5 mmol/L) were made in deused to monitor changes in intestinal permeability in ionized water. From the stock mannitol solution, we various disease conditions (4,5). We have found that the pipetted 20, 40, 60, 80, and 100 AL into disposable enzymatic methods commonly used to determine mani...

Inguinal hernias are a common cause of abdominal wall pain and are the most common abdominal wall abnormality. They can usually be differentiated from other abnormalities by history and physical examination. Occasionally, the diagnosis may be difficult with very small or very large lesions. The following case report describes an abdominal wall neurofibroma presenting as an inguinal hernia in a young, active duty, male soldier with previously undiagnosed neurofibromatosis.

Postoperative abdominal adhesions are a significant cause of morbidity and expenditure of healthcare resources. As a result, numerous substances have been studied in an effort to reduce the incidence of adhesive disease. Seprafilm, a hyaluronate-based bioresorbable membrane, has been the subject of considerable research and has been found to be both safe and effective in reducing postoperative adhesions. We report three cases of the development of sterile abdominal fluid collection after the use of Seprafilm in colorectal surgery.

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