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Controversy still surrounds the use of extracorporeal life support (ECLS) in patients with single ventricle physiology. An analysis of the experience with a group of neonates who underwent stage I Norwood palliation and received ECLS is reported.

In recent years, laparoscopic surgery has become a matter of growing interest. It has been shown that laparoscopic colectomy is well tolerated and safe for benign disease. However, there is some uncertainty about using this method for malignant disease when curative resection is the aim. These uncertainties mainly consist of spread of cancer to port site, long-term survival, and adequacy of resection. The majority of laparoscopic colectomies are technically assisted procedures in which anastomosis is performed outside the abdomen. However, some surgeons are now performing this surgery totally laparoscopically with the anastomosis performed inside the abdomen. Laparoscopic colectomy is currently practiced with great frequency by general surgeons. Its performance requires a steep learning curve and a large number of cases to obtain proficiency. The indications for laparoscopic colectomy are different from one institution to another. In some institutions all patients with colorectal disease are candidates for laparoscopic colectomy and in others it may be limited to benign disease only. The purpose of this review is to analyze all laparoscopic colectomies performed at our medical center since 1992. We conducted a retrospective chart review of both hospital and clinic charts of patients who underwent colectomies at our hospital. A total of 338 patient charts were reviewed. In a comparison of both laparoscopic (n = 285) and converted (n = 53) methods, the age and operative time were about the same. Age average and operating room time average were similar for both groups. With laparoscopy, there was a 3-day drop in length of hospital stay as well as a 1-day-earlier regaining of bowel function. Hospital cost dropped $5000 average for the laparoscopic colectomy. The conversion rate at our center was 15 per cent. Complication rates were lower in the laparoscopic group. Recurrence of cancer at the port site (0.7%) was no higher than in the converted group (incisional recurrence, 1.8%). We conclude that laparoscopic colectomy does show an improvement in return of bowel function, hospital cost, and shorter hospital stay. Long-term follow-up will be necessary to determine the effectiveness of laparoscopic colon resection for colorectal cancer.

Among the biochemical processes initiated by anoxia or ischemia that play a central role in cellular injury during deprivation is an alteration in cellular hydrogen ion concentration. In this study, the rate of exchange of intracellular hydrogen ion concentration in canine brain was compared with that in liver, using the 5,5-dimethyloxazolidine-2,4-dione method during anoxia at 37 and at 20 degrees C. The intracellular pH of brain decreased more rapidly than it did in liver anoxia at 37 degrees C. The intracellular pH of neither brain nor liver changed substantially during 30 min of anoxia at 20 degrees C. Although the ratio of tissue to plasma water did not change, the calculated extracellular-to-intracellular volume ratio increased during 30 min of anoxia at 37 but not at 20 degrees C.

The addition of 100 (µg/L of Aroclor® 1242 (A1242) or 2,5,2',5'-tetrachlorobiphenyl (TeCB) during 10 week chronic toxicity tests withHyalella azteca resulted in complete mortality. There were no effects on survival, growth, or reproduction after addition of 30 µg/L. Toxic effects were observed at tissue levels of between 30 and 180 µg/g on a wet weight basis, and tissue levels appear to be a better indicator of toxicity than levels in water. No toxic effects were observed after additions of up to 2,700 µg/L of the coplanar congener 3,4,3',4'-TeCB.H. azteca has the ability to avoid accumulating in excess of 140 µg/g 3,4,3',4'-TeCB. The amount taken up was proportional to the amount added in water up to 100 µg/L, but was constant at higher additions, possibly accounting for its relatively low toxicity. The low toxicity of the coplanar congener, as compared to the non-coplanar 2,5,2',5'-TeCB, is in direct contrast to the high toxicity of coplanar PCB congeners to mammals and may be associated with slower rates of aromatic hydrocarbon metabolism in amphipods. Polychlorinated biphenyl levels measured in amphipods from Lake Ontario are approximately 100-fold below levels associated with toxicity inH. azteca, but are above levels which, through biomagnification up the food chain, lead to salmonid residues in excess of 2 µg/g, a tolerance limit for human consumption.

A set of pseudorevertants of lactose operator-constitutive (lacOc) mutant has been obtained. Analysis of a subset of these pseudorevertants indicates that, in some cases, the secondary mutation alters the lactose repressor (lacl gene product), whereas in others it seems to have occurred in the lactose operator (lacO) itself. Of the lacl gene mutations, the lacl8 mutation, already known to suppress all lacOc mutations nonspecifically, was recovered by a selection technique developed for this study. However, two additional lacl gene mutants were selected which appear to suppress lacOc sequences in a more-or-less specific fashion; repressor interaction with some operator sequences is facilitated, whereas the binding with lacO+ and others is attenuated concomitantly.

Associated with the production and fabrication of Pu239is the hazard of its entry to the body through inhalation or breaks in the skin. It is not possible to estimate, with any degree of accuracy, the amount of residual plutonium in the lungs when it is very insoluble. Bone is considered the critical organ for soluble Pu239, while damage to the lungs presents the greatest hazard from insoluble Pu239. However, poorly soluble Pu239may concentrate in peribronchial lymph nodes where it constitutes a distinct hazard. Certain slightly soluble Pu239compounds deposited in subcutaneous tissue may cause fibrosarcomas. If we may extrapolate from mice to man, this hazard to soft tissue could be considered comparable to the hazard to bone. Deposits of plutonium or its compounds in subcutaneous tissue should, therefore, be removed as thoroughly as possible by decontamination procedures, including surgery. The elimination rate of Pu239from the body by urinary excretion is increased by a factor of 50–100 by the intravenous administration of DTPA. It is recommended that DTPA be administered as quickly as possible following any incident in which it is expected that the maximum permissible deposition will be exceeded. DTPA is less effective when given orally than when administered intravenously. When therapy is continued for long periods, effectiveness decreases markedly, but effectiveness returns again after therapy has been stopped for several months.

The experimental observations described in the following paragraphs were prompted by the reports of Holmes and his associates1 on the beneficial effects of the administration of ascorbic acid to persons suffering from chronic lead poisoning. These investigators noted a decided reduction in the symptoms of exposed workmen and an apparent decrease in the lead content of the blood and the urine following the daily ingestion of ascorbic acid. This was associated with an increase in the number of erythrocytes, a decrease in the number of stippled erythrocytes and an increase in the hemoglobin content of the blood. They inferred that ascorbic acid combined with lead to form a relatively insoluble or unionized compound that might be eliminated through the bile into the feces.The importance of these conclusions, from a practical point of view, stimulated our efforts to verify them. If they proved to be true in our hands,

A simple determination of percent body fat would enhance the physician's ability to advise on weight control. The estimation of percent fat from (1) radioactive potassium levels, (2) height-weight measurements, (3) skinfold measurements on the scapula, and (4) skin-fold measurements on the triceps was compared statistically for 235 males. A nearly optimum estimate of percent fat was obtained by averaging the estimates of percent fat from the scapula skin-fold measurement and the heightweight measurement. The interval defined by this average ± 6.3% will contain the true percent fat for the individual about 95 out of 100 times.

With the ever-expanding use of radioisotopes, the possibility for accidental deposition within the body is increasing. Therapy for such conditions becomes most important. This paper is an attempt to summarize available information in this field as concisely as possible.

Accumulating evidence suggests that the genetic damage to the human gonads due to exposure to ionizing radiation is greater than previously thought. This, with the greater potential for exposure of whole populations in medicine, industry, and defense, has resulted in increasing concern over genetic injury to whole populations. Debates among scientists over the amount and effect of radiation due to fall-out from testing atomic weapons have made the American public more aware of the hazards of radiation. This is a healthy state of affairs, if perspective can be maintained on the part of both the medical profession and the public.Considering the relative genetic hazards to whole populations from man-made radiation, we find that by far the largest contribution comes from diagnostic radiology. At the same time, the judicious use of diagnostic radiology is one of medicine's most important tools.Much remains to be learned regarding the actual exposures being

A large number of workmen are required to wear leather gloves or gloves of similar type for protection while working. A definite increase in the incidence and severity of dermatophytosis has occurred during recent years.1 This makes consideration of the subject important to dermatologists, industrial physicians and general physicians who see many cases of eczematoid dermatitis of the hands.In this study we have endeavored to determine the relative importance of gloves and dermatophytosis of the feet (athlete's foot) in the production of a particular type of eczematoid dermatitis of the hands.For several years we have noticed that many of the workmen in the section of our plant manufacturing tetra-ethyl lead contract eczematoid lesions of the hands. Previously the rash was considered to be an eczema having no relation to work. During these years many patients have been treated by family physicians and several have been referred in