[Splenic abscess, a diagnostic and therapeutic problem]. / El absceso esplénico, un problema diagnóstico y terapeútico.

Splenic abscess remains a rare entity, reserved for patients with predisposing factors or immunosuppressive conditions. In our 13 patients in which a splenic abscess was diagnosed pre- or intra-operatively, an average of 14 days past before the diagnosis was made. Main symptoms were fever, upper left abdominal pain, auscultatory left basal anomalies and splenomegaly. Culture from the spleen material included E. coli, Staphylococcus, Proteus, Salmonella and Streptococcus v. Although splenectomy has been considered the standard procedure for this pathology, we treated our last three patients by means of Computed Tomography Percutaneous Drainage (C.T.G.P.D.). There was no need for splenectomy after this procedure and there were no complications associated with the C. T. G. P. D.

Adjustable nylon ties for abdominal wall closure.

A study in 64 patients with a high risk of wound dehiscence or eviscerated wounds or in whom repeat laparotomies for peritoneal lavages due to sepsis were planned was accomplished using adjustable nylon ties for the closure of the abdominal wall, either as retention sutures or as one-layer sutures. The adjustable nylon ties are described, as well as the technique for placing and adjusting them. It is concluded that the adjustable nylon ties can substitute advantageously for the conventional retention sutures since the former are wider, easy to place, and can be readjusted to the point that they can be opened completely if it is necessary and then closed again. This is especially useful when repeat laparotomies for peritoneal lavages are required in patients with intra-abdominal sepsis.

[Bacterial translocation in a model of intestinal obstruction. II. Bacteriological study and role of cellular immunity]. / Translocación bacteriana en un modelo de obstrucción intestinal. II. Estudio bacteriológico y papel de la inmunidad celular.

Bacterial translocation (Bt) from the gastrointestinal (GI) tract to systemic organs creates the possibility of Infection and sepsis in a great number of pathologic entities. In a mouse model of Intestinal Obstruction (IO), we evaluated the type of micro-organisms and the organs that bacteria frequent translocated. At 24 hours post-10, positive cultures where obtained at the MLN, portal, systemic circulation and peritoneal cavity, establishing that the translocation is bi-directional. The more frequent bacteria isolated were the Streptococcus group D, Proteus mirabilis, Escherichia coli, Pseudomonas sp., an clostridium. BT occurs at 24 hour post-OI and was due to increased intestinal permeability, at 48 hrs BT increased and related to the physical disruption of the mucosal barrier in the intestinal mucosa. Cell mediated immunity (CMI) response in this model was not altered, although a progressive decrease was observed at 48 hrs it was not significant, suggesting that the CMI play no role in the pathogenesis of BT. In the Control-Laparotomy group, CMI response was increased significantly at 48 hours, suggesting that a simple laparotomy boost the immune defense response.

Prevalence of cervical dysplasia and HPV infection according to sexual behavior.

A total of 165 uterine cervix smears from Venezuelan women were examined by cytological techniques to identify malignant and pre-malignant cervical changes, as well as to identify Human Papilloma Virus (HPV) DNA types 6, 11, 16, 18, 31, 33 and 35. Of these smears, 119 were from nonmonogamous women who participated in a cervical carcinoma screening program. In this group, HPV-DNA was detected by hybridization in 42 samples (35%) and cervical intraepithelial neoplasia (CIN) in 13 (11%). Forty-six monogamous aboriginal women were similarly studied and no evidence of abnormal cytology or HPV-DNA of the types studied here was found in any of them. In the non-monogamous group, age at first sexual intercourse and index of parity were not associated with cervical HPV infection and/or CIN. The rates of HPV infection, however, were significantly different between the two populations, confirming that sexual behavior involving multiple partners is associated with HPV infection.

Analisis de la secrecion gastrica.- Descripcion del procedimiento. Calculo por computadora. / Gastric secretion analysis. Description of the procedure. Calculation using computers

Los autores hacen una revision del metodo tradicional para determinar la secrecion gastrica y la manera de titular las muestras del material obtenido con el fin de calcular los valores de BAO y PAO haciendo hincapie en las detalles mas importantes.Como parte fundamental del trabajo se diseno un programa en lenguaje basico para simplificar los calculos, utilizando una computadora 5110 IBM

Effect of sodium taurocholate on gastric secretion in patients with duodenal ulceration.

The effect of sodium taurocholate instillation on the stimulated stomachs of patients with duodenal ulceration has been investigated. Instillation into the stomach of sodium taurocholate significantly reduced pentagastrin stimulated volume and outputs of both acid and sodium, with no change in the calculated volume of duodenogastric reflux. These observations are not consistent with the back-diffusion theory, but suggest direct parietal cell inhibition of gastric secretion by sodium taurocholate.

[5 years' experience with parietal cell vagotomy]. / Cinco años de experiencia con la vagotomía de células parietales.

The authors presents five years experience with the Parietal Cell Vagotomy in 65 cases. In this group 54 of them had duodenal ulcer, 7 cases presented duodenal ulcer and Hiatal hernia. Only 4 cases presented hiatal hernia. Clinical, radiological and gastric secretion controls show a satisfactory evolution and considerable reduction in the ion H+ concentration. The authors presented in their series 4.6% recurrence in the D.U. group, the morbidity was 1.5%, they did not report operative mortality.

Reconstrucao anatomica do anel pilorico.Estudo experimental em cachorros. / Anatomic repair of the pyloric channel. Experimental study in dogs

Informa-se sobre os resultados de pesquisas concernentes ao comportamento morfologico e fisiologico do canal pilorico, depois da sua seccao e reparacao anatomica, no campo da cirurgia experimental. Utilizaram-se sete ou oito caes em condicoes normais de saude, compreendidos entre 14-17 quilos de peso, nos quais foram praticadas previamente a seccao e a reparacao anatomica do piloro no seu diametro maior, uma medida do canal pilorico com sondas cirurgicas de Hegar, que indicou uma amplitude da luz pilorica em 15 e 17 mm., em condicoes normais. Depois de um periodo de observacao, em media de 24 semanas, procedeu-se a reopera-los medindo a amplitude do canal pilorico, que nao mostrou variacoes e ressecando a continuacao a area correspondente a esse canal. Nos estudos anatomopatologicos macro e microscopicos nao se demonstraram alteracoes estruturais. Os resultados destas pesquisas recomendam continuar os estudos que permitam dar bases confiaveis para aplicar a tecnica a que se refere o trabalho em casos humanos, nos que seja necessaria a seccao do canal pilorico para deter sangramentos originados por uma ulcera duodenal, substituindo desta forma a piloroplastia tradicional pelos problemas de drenagem gastrica que podem ser observados com este procedimento

Cinco anos de experiencia con la vagotomia de celulas parietales / A 5 years' experience with vagotomy of parietal cells

Los autores presentan 5 anos de experiencia con la vagotomia de celulas parietales en 65 pacientes intervenidos en el Servicio de Cirurgia No. 2 del Hospital Vargas de Caracas, Venezuela. Fueron intervenidos por ulcera duodenal 54 pacientes, 7 pacientes con ulcera duodenal asociada a hernia hiatal y 4 pacientes con hernia hiatal solamente. Controles clinicos, radiologicos y de secrecion gastrica demostraron la utilidad de la intervencion, fundamentalmente en la reduccion de la concentracion de acido clorhidrico que alcanzo un descenso promedio de 87.6%. La recidiva fue observada en el 4.6% de los casos. La mortalidad fue del orden del 1.5% y no se registro mortalidad operatoria