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Fifty-five patients of mean age 69 (range 41–96) years with rectal cancer (Dukes' A: B: C, 11:24:20) underwent anterior resection using a double stapling technique under the care of one consultant surgeon between 1983 and 1988. The mean distance of the anastomosis from the anal margin was 7.2 (range 4–13) em. The clinical leak rate was 9 per cent (five patients). There were three postoperative deaths from pulmonary embolism, lower limb ischaemia and renal failure. On prospective follow-up, 35 patients had no evidence of local or systemic cancer a median of 32 (range 24–84) months after operation; seven have died from unrelated diseases and ten from metastatic cancer. Pelvic recurrence, in four patients at 9, 11, 12 and 50 months, has occurred only in association with widespread metastasis. These results suggest that the theoretical risks of an increase in the local recurrence rate rectal cancer after resection using a double stapling technique are not substantiated.

In a randomized controlled study of 411 patients undergoing elective colorectal surgery, the efficacy and safety of two different regimens of imipenem were compared with those of a control regimen of cefuroxime plus metronidazole. Surgical infections occurred in 92 (26·4 per cent) of 349 evaluable patients. There were no major differences between the three treatment groups. It is concluded that imipenem is as effective as cefuroxime plus metronidazole in the prevention of sepsis after elective colorectal procedures.

The paper describes a methodological approach to the investigation of maternal-fetal transfer of lead in a non-human primate species, with particular focus on skeletal tissue, which is known to be a site of lead deposition. Eight female cynomolgus monkeys were dosed with lead acetate during gestation, and in four of the animals, the isotopic composition of the lead was modified by enriching the amount of the stable isotope 204Pb included in the dose. Biopsy and dissection procedures for the preparation of bone samples for lead analysis and stable lead isotope analysis are described. Emphasis is placed on the containment of potential contamination of the samples by lead during preparation. Containment procedures included: use of a Class 100 clean room, special cleaning regimes and use of Teflon containers and stainless steel instruments. Preliminary data of lead concentrations in adult bone (trabecular and cortical) and fetal bone subsequent to the dosing regimen of lead during pregnancy, suggest notable differences between the two bone "compartments" examined. The bone samples of fetuses from the dams which had received enriched 204Pb showed drastically reduced 206Pb/204Pb isotope ratios.