Concept of a duct-to-mucosa pancreaticojejunostomy

The anatomy of the main pancreatic duct, as illustrated in Gray's Anatomy, comprises numerous branch ducts draining into the main pancreatic duct in a herringbone fashion. The presence of branch ducts is, of course, also well described in the present classification of intraductal papillary mucinous neoplasm (IPMN) into main duct and branch duct variants. During a standard Wirsungojejunostomy, the branch ducts are not engaged into the anastomosis and can logically "leak" outside the anastomosis, contributing to a postoperative pancreatic fistula (POPF). In fact, in rare cases a minor duct of Santorini may be present at the cut surface of the pancreas, and, if small and not identified, it will also not be engaged into aduct-to-mucosa anastomosis.

Prolapse of the urethral mucosea in prepubertal West Indian girls

Forty-two cases of urethral mucosal prolapse were reviewed in Trinidad, West Indies. The main presenting symptom was vaginal bleeding; 31 percent of patients had associated infection and 97 percent belonged to social classes III to V; 33 percent had conservative management and 67 percent had surgical treatment. It was concluded that treatment should be medical rather than surgical and it is suggested that this is a disease of the low socio-economic group (AU)

Water content level in inspired air on specific airway resistence in rats

The effect of increasing water content in inspired air on specific airway resistence in rats was assessed. The results show that specific airway resistances were significantly related to the water content of the inspired air, above 15.02 mg/m3, the duration of water content exposure and to the type of water nebulized. It is suggested that the increase is composed of a local and neural element caused by accumulation of mucus or mucosal swelling and changes in the composition and consistency of the mucus lining layer, respectively (AU)

Distribution of bronchial gland measurements in a Jamaican population

Measurements of the gland thickness and Reid index have been made on bronchi obtained at necropsy on 53 male and 52 female Jamaicans. The mean values for the Reid index and mucous gland thickness obtained were 0.314 and 0.192mm. for males, and 0.302 and 0.170mm. for females respectively. No significant increase in values was seen with age, although the data suggest this trend. The results have been compared with data published from Montreal and the same overall Gaussian distribution is seen. This supports the suggestion that the gland measurements in non-bronchitic and bronchitic subjects do not fall into two distinct groups but are part of a continous distribution. The similarity of the two studies is also of interest as the populations are drawn from two distinct environments, one from a non-industrialized tropical island, the other from a large city in the northern hemisphere.(AU)

Prolapsed urethral mucosa

The condition of prolapsed urethral mucosa occurring predominantly in Negro population, has been examined by many observers. No conclusive theory has yet been put forward but many possibilities existing alone or in combination are likely aetiological factors. The facts evolving from this series eliminate such factors as malnutrition, intestinal parasites and constipation as causative factors. The more complex theories have not been disproved, but in view of good results obtained by simple excision, the cause is more likely to be local in the prolapsed portion of the urethra, e.g. redundancy of tissue, laxity of tissue and infection. The symptoms are of rather constant pattern and separation into a chronic and acute picture may be made. Acute - In these, the history is of short duration; bleeding is usually the presenting symptom. The prolapsed mucosa is haemorrhagic, bleeding or gangrenous and is very tender. Chronic - There may be a history of spotting or of a vaginal discharge that may be blood stained. The mass looks like normal mucosa; it is often not tender. In addition, chronic infection may be found on microscopy. An acute episode may be superimposed. (Summary)

Lesions of the urethra

Three particular conditions of the urethra appear to be commoner in the tropics than elsewhere, and are puzzling to those who see them for the first time. These are prolapse of the mucosa, diverticulum, and complete or partial destruction (AU)