In a randomised study of 34 patients undergoing elective operations of moderate severity naftidrofuryl infusion significantly improved postoperative nitrogen balance. The control group excreted 26.2 +/- 2.7 g nitrogen in the first three postoperative days. A group treated with naftidrofuryl excreted 18.0 +/- 1.6 g nitrogen in the same period (p less than 0.0005). The preoperative nutritional state of patients treated with naftidrofuryl did not differ from that of the controls. Though hormonal changes causing an improvement in nitrogen balance could not be excluded by this study, the results show that naftidrofuryl infusion may stimulate postoperative catabolism of endogenous carbohydrate and fat, thus sparing tissue protein.
The Vereshchagin episode, describing the execution of a young student during the fall of Moscow in 1812, occupies Chapters 24 and 25 of Part 3, Book 3 of Lev Tolstoi's Voina i mir (War and Peace). This dramatic scene, in which Mikhail Vereshchagin is cut down by a dragoon on the order of Count Fedor Rastopchin, has received little critical attention given the breadth of work on the novel as a whole. This is understandable on the grounds that the text does not constitute a large portion of Voina i mir and its characters are far from principal players. Yet investigating the episode reveals how Tolstoi deliberately added psychological, ideological, and theological subtexts to the early drafts, marking such subtexts by changes in narration, language, and direct allusions. Episodes such as this one are intricately structured to produce emotions, raise questions, and initiate a philosophical inquiry into the actions and thoughts of the characters concerned.
Local tumor recurrence following restorative surgery for colorectal cancer may occasionally result from the promotion of a neoplastic lesion in a zone of proliferative instability adjacent to the anastomosis. The aim of this study was to compare the influence of three anastomotic suture materials, including stainless steel (as a model of surgical stapling), on colorectal carcinogenesis in an experimental animal model. The transmural implantation of stainless steel sutures into the distal descending colon of albino Swiss rats during the postinitiation phase of tumor induction resulted in significantly fewer animals exhibiting perianastomotic tumors 12 weeks later (3 of 21 animals) when compared with either polyamide (Nurolon; Ethicon, Edinburgh, United Kingdom) (14 of 20 animals; P less than 0.001) or polyglycolic acid (Dexon Plus; Davis and Geck, Gosport, United Kingdom) sutures (17 of 21 animals; P less than 0.001). The findings were similar when the same materials were used to resuture a longitudinal colotomy. For both operative procedures, the type of suture material had no influence on the incidence of large bowel tumors distant from the anastomotic site. These results suggest that stainless steel staples may promote fewer perianastomotic large bowel tumors than certain more conventional suture materials and, therefore, may be safely employed in colorectal cancer surgery.
are percentages clinical diagnostic error rate is so high that attempts at clinical separation of direct from indirect inguinal hernia have no practical value.
Abstract Solar flares are thought to be caused by reconnection of magnetic fields and their associated electric currents in the solar corona. The currents have to be there to provide available energy over and above the current-free minimum energy state, but what generates them has been little discussed. This paper investigates the idea that twisting motions in the turbulent convection zone below may provide a natural source for the currents and explain some of their properties. The twists generate upward-propagating Alfvén waves with a Poynting flux of the right order of magnitude to power a flare. Depending on the depth it takes place, the twisting event that initiates a particular flare may occur hours, days or even months before the flare itself.
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