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The adsorption technology based on low-cost adsorbents is of great interest for alternative sustainable abatement of toxic heavy metals from dilute industrial wastewaters. In this study, the perfor...

The aim of this pilot study was to determine VEGF serum levels (S-VEGF) at diagnosis and at restaging in children diagnosed with cancer, and to investigate whether this parameter provides prognostic information for remission after induction therapy and response to treatment. S-VEGF levels of 35 consecutive pediatric patients with various types of cancer were assayed at diagnosis and at restaging. Levels of VEGF were determined using a commercially available ELISA anti-human VEGF immunoassay kit. Thirty-one children went into complete remission or had a very good partial response to first-line therapy; 4 patients developed tumor progression. At diagnosis average S-VEGF level was 495 pg/mL (range, 0.89--2220 pg/mL) and at restaging it decreased to 118.36 pg/mL (range, 7.44--487 pg/mL). (p=.0039). The 4 patients with tumor progression had increased S-VEGF levels at restaging. The comparison between the levels of S-VEGF at diagnosis and at restaging showed a significant difference for the patients who responded to treatment with decreased S-VEGF and the patients who developed tumor progression with increased S-VEGF (p=.0019). One child with metastatic Ewing sarcoma developed progressive disease after several weeks, with significantly progressively higher S-VEGF levels. One child with Hodgkin disease, who had a higher level at first restaging and developed progressive disease, responded to reinduction therapy and had a significantly lower level at the second restaging. The child with metastatic hepatoblastoma responded to first-line chemotherapy with concomitant decrease in S-VEGF and alpha-fetoprotein levels, but developed local recurrence with elevation in both parameters. Changes in S-VEGF levels correlated with response to treatment for most of the children diagnosed with cancer. This provides a rationale for exploring clinical interest in S-VEGF measurements of a larger group of children with malignancies, and using the test for clinical trials of antiangiogenic therapies.

We report the effect on the neurosurgical wound infection rate of a modification of the 'Malis' technique of antibiotic prophylaxis. In this a combination of antibiotics is given in the form of both parenteral administration and wound irrigation. A series of 1173 clean neurosurgical operations was compared with a historical control of 303 operations. Both treatment and control groups were operated on by the same surgeon, using similar surgical techniques. The control group received parenteral pre- and postoperative antibiotics (flucloxacillin and ampicillin). The treatment group (where the parenteral antibiotics used was cephradine) also received wound irrigation with a solution of gentamicin and flucloxacilin. The infection rate was 0.42% in the treatment group (five patients), in the control group it was 3.96% (12 patients). The difference was highly significant (p = 0.00006). We believe that the use of wound irrigation with antibiotics should receive further study.

We report the long-term outcome in 80 patients who had undergone extended anterior cervical decompression without fusion for cervical nerve root or spinal cord compression. Follow-up ranged from 2 years 4 months to 13 years. Five patients had died from causes unrelated to the original pathology or the surgery. Of the remaining 75 patients, 66 (88%) were symptom free or clearly improved, eight (10%) were unchanged and one patient (1.5%) was worse. Sixty-eight patients (91%) were satisfied with the outcome of treatment. Nineteen patients (25%) had some degree of residual neck pain, but in none was this a major problem. Three patients had required subsequent surgery for cervical disc protrusions at levels adjacent to the first operation, while two patients had developed foraminal stenosis at the level of the surgery and had undergone foraminotomy. One patient had developed a symptomatic flexion deformity. Radiological assessment revealed bony fusion in 71%, some degree of flexion deformity in 13% and some de...

Between 1983 and 1994, posterior cervical foraminotomy as described by Frykholm was performed on 89 patients with exclusively radicular symptoms caused by cervical osteophytes. The main presenting feature was arm pain. Objective neurological signs were present in 50% of the patients. At mean postoperative follow-up of 8.6 months, 95.5% of patients reported excellent or good results, while 4.5% were not improved. No patient was rendered worse following the procedure. There were no deaths and the complication rate was 2.2%. Further surgery for recurrent root symptoms was required by 6.7% of patients. Our findings are in keeping with the good results and low complication rate of this procedure as described in other studies. Informal inquiries suggest that this procedure is not widely used, at any rate in the United Kingdom, and we present this series in order to emphasize the efficacy and safety of this procedure.

We report the case of a man of aged 27 years who presented with obstructive hydrocephalus caused by a colloid cyst of the third ventricle. He was found to have an additional and larger colloid cyst lying adjacent to it, but within the lateral ventricle. The contents of the two cysts were of different consistency. We have been able to find only one previous report of more than one colloid cyst occurring in the same patient and none where one of the cysts lay within the lateral ventricle.

Of 291 operations performed for cervical degenerative disease causing cord or root involvement over a 12-year period 187 have been treated by extended anterior discectomy without fusion, removing bone on either side of the posterior disc space so as to give a wide exposure of the anterior spinal and root dura. The technique has been used for 73% of the cases operated on in the last four years. Nine patients (4.8%) required an additional posterior decompression for coexisting spinal or root canal stenosis. By the first postoperative follow-up at 2-4 months 94.5% of patients showed clear neurological or functional improvement, 3% were worse and 1.5% had died (the deaths were in elderly patients with severe myelopathy and intercurrent disease). Minor treatable complications occurred in 3.2%. Only two patients (1%) complained of persistent postoperative neck pain. Patients were mobilized immediately after surgery without a collar and most left hospital within 1-4 days. A single level decompression was sufficient in 92% of patients and only one patient required more than two levels to be decompressed. In 79% of cases soft disc protrusions contributed to the compression while in 21% osteophytes alone caused the compression. We believe that this simple technique is a sufficient surgical treatment for the majority of cases of cervical degenerative disease. It does not require a fusion and avoids the specific problems and complications associated with Cloward type operations. We are engaged at present in a long-term follow up study of these patients, but to date no late problems have become apparent.

Sexual behavior change to reduce the risk of HIV infection is a dynamic multi-staged process. We present an empirical model for change, where we describe a stage of initiation of safer sexual practices, followed by a consolidation stage, and a long-term maintenance stage. The process of change can be interrupted by occasional or repeated lapses. We apply this multi-stage model to sexual behavior in a cohort of gay men from the Chicago area. The prevalence of various stages are reported between 1986 and 1991. Men infected with HIV tended to initiate change to safer sex later than those who were not, but maintained change or relapsed to unsafe practices in the same proportion. Implications regarding factors associated with relapse to unsafe sex, and interventions to prevent relapse, are discussed

A method for the routine determination of both free and total sulfur dioxide (SO2) residues in malt and total SO2 in beer is described. The basis of the method relies on the systematic formation of...

We have investigated the effect of age on the outcome of first time surgery for intracranial meningiomas. In a retrospective study, 144 consecutive patients were divided into three groups: young (up to 44 years of age, 38 patients), middle-aged (45-64 years, 60 patients) and elderly (65 years and over, 46 patients). Outcome was assessed at the first follow-up appointment 4-6 months after discharge. The surgical mortality was 2.7%. The incidence of significant intercurrent disease increased with age (11, 25 and 35%, respectively), as did the incidence of postoperative complications (16, 23 and 30%). Postoperative intracranial bleeding was especially age-related, occurring in 20% of the elderly group as against 0% of the younger. Although the younger patients did best (100% in Glasgow Outcome Scale Grade 5) there was no difference in outcome between the middle-age and elderly groups (88 and 83%, respectively). Of the elderly patients, 89% showed clear functional improvement after surgery, 2% were unchanged and 9% were worse or dead. The intellectual deterioration apparent in over half of the elderly patients recovered after removal of the tumour in 80%. We conclude that age has little effect on the prospects of success after removal of an intracranial meningioma.

In the past, individual malthouses maintained on-site laboratories, capable of handling limited numbers of samples on a daily basis. Cost-effectiveness dictated the streamlining and centralization of quality assurance laboratories, which must be prepared to analyze more samples for more parameters. The availability of reference-quality automated methods allows precise analysis with minimization of cost and turnaround time. The various capacities in which a company may benefit from automating their laboratory systems will be discussed.

Neurosurgeons have always tended to be slightly behind the times, perhaps an inevitable feature of a branch of medicine which requires a rather conservative and obsessional personality in order to be successful. This general rule holds true when one considers the question of surgery in old age. While other types of surgeon have become aware of the growing importance of the elderly as a group demanding medical attention, neurosurgeons have paid relatively little attention to this subject until recently.

(1993). Huw Griffith 1930–1993. British Journal of Neurosurgery: Vol. 7, No. 6, pp. 597-598.

In 76 consecutive patients with spinal cord compression the process of diagnosis and referral was investigated. This investigation was carried out at the time of admission to the neurosurgical unit when it was possible to obtain fresh information about each patient's pre-admission management. All the patients had been referred from District General Hospitals and 71 had previously consulted their general practitioners. Sixty-two per cent took over a week from the time they first saw their own doctor to reach the referring hospital, after reaching hospital 47% of patients waited a week or more before they were referred to a neurosurgeon. During the process of referral, the proportion of patients able to walk unaided and control their sphincters fell from 68% to 10% while the proportion with complete cord lesions rose from 1.5% to 28%. In 48% of cases there had been delays in diagnosis and referral which appeared avoidable. The reasons for these delays and their effect on the eventual outcome are assessed.

A sentinel health information system using a telematics system to collect epidemiological data from a network of general practitioners (GPs) making up 5% of the GP population was set up in October 1986 in Aquitaine, France. In the first year, four topics were under surveillance. The GPs reported data for each case diagnosed by filling out a questionnaire displayed on their home terminal (Minitel), which transmitted the data by standard telephone lines to a central minicomputer located in the Bordeaux University Medical Centre. Regular feedback was provided to the participating GPs, public health officials and the Bordeaux Medical School. A detailed report of GP participation is presented, the reliability of our findings is discussed in terms of the motivational factors of participants, and the usefulness of the system is evaluated both for immediate teaching implications and for future research possibilities.

A case of disc prolapse expanding the lumbar spinal canal by eroding the dorsal aspect of the body of L4 vertebra is reported. Despite no previous reports this condition is not considered to be extremely rare.