Current transport of leatherback sea turtles (Dermochelys coriacea) in the ocean

While the long-distance movements of pelagic vertebrates are becoming known thanks to satellite telemetry, the factors determining their courses have hardly been investigated. We have analysed the effects of oceanographic factors on the post-nesting movements of three satellite-tracked leatherback turtles (Dermochelys coriacea) moving in the southwest Indian Ocean. By superimposing the turtle tracks on contemporaneous images of sea-surface temperatures and sea height anomalies, we show that currentrelated features dominate the shape of the reconstructed routes. After an initial offshore movement, turtles moved along straight routes when in the core of the current, or executed loops within eddies. Large parts of the routes were strikingly similar to those of surface drifters tracked in the same region. These findings document that long-lasting oceanic movements of marine turtles may be shaped by oceanic currents.

Leptin serum levels are involved in the relapse after weight excess reduction in obese children and adolescents

BACKGROUND

Leptin concentrations as a predictor of weight excess (WE) variations in obese children continue to be controversial.

AIM AND DESIGN

To evaluate the relationship between fasting leptin serum concentrations and the ability to maintain loss of WE during obesity treatment, 172 (82 males and 90 females) overweight children and adolescents (OW), 6-16 yr old, were recruited. The subjects were retrospectively selected among those who had demonstrated a reduction of their WE during an initial phase of 12 months of a WE reduction programme (WERP). Fasting serum levels of leptin were assayed, together with insulin, triacylglycerol and cholesterol, before (time 0) and at the end of the first phase of WERP (time 1), and BMI (Z-score) was determined at time 0, time 1 and at the end (time 2) of a subsequent second phase of 12 months. OW were subdivided according to wether their Z-BMI showed a persistent reduction also during the second phase (maintaining WE reduction subjects or MS) or showed a subsequent increase after the reduction observed during the first phase (relapsing WE subjects or RS).

RESULTS

A significant reduction in serum levels of leptin, insulin and lipids, paralleling Z-BMI reduction, was observed at the end of the first phase of WERP, during which we found a correlation between the decrease in serum leptin concentrations and the decrease in Z-BMI. The decrease in RS during the first phase ((deltalgL(0-1) was significantly greater when compared to that observed in MS (p < 0.05). In two different multiple logistic regression analyses, where RS = 0 and MS = 1, serum leptin at time 1 [odds ratio (OR) = 1.08; 95% confidence interval (CI) = 1.04-1.13] and deltalgL(0-1) (OR = 0.48; 95% CI = 0.25-0.92), together with final pubertal stage (OR = 0.78; 95% CI = 0.63-0.96), were significantly associated with final subject status.

CONCLUSIONS

Leptin serum levels after a previous WE reduction and its parallel decline are related to subsequent adiposity outcome. The lower the leptin serum concentration after previous WE reduction and/or the greater its decrease, the greater was the probability of WE relapse.

The diving behaviour of green turtles undertaking oceanic migration to and from Ascension Island: dive durations, dive profiles and depth distribution

Satellite telemetry was used to record the submergence duration of green turtles (Chelonia mydas) as they migrated from Ascension Island to Brazil (N=12 individuals) while time/depth recorders (TDRs) were used to examine the depth distribution and dive profiles of individuals returning to Ascension Island to nest after experimental displacement (N=5 individuals). Satellite telemetry revealed that most submergences were short (&lt;5 min) but that some submergences were longer (&gt;20 min), particularly at night. TDRs revealed that much of the time was spent conducting short (2–4 min), shallow (approximately 0.9–1.5 m) dives, consistent with predictions for optimisation of near-surface travelling, while long (typically 20–30 min), deep (typically 10–20 m) dives had a distinctive profile found in other marine reptiles. These results suggest that green turtles crossing the Atlantic do not behave invariantly, but instead alternate between periods of travelling just beneath the surface and diving deeper. These deep dives may have evolved to reduce silhouetting against the surface, which would make turtles more susceptible to visual predators such as large sharks.

Leptin serum concentrations predict the responsiveness of obese children and adolescents to weight excess reduction program

BACKGROUND

A role for leptin to predict weight gain is still controversial.

OBJECTIVE AND DESIGN

To determine the relationship between baseline serum leptin values and responsiveness to an educational-based weight excess reduction program (WERP), 418 (241 males and 185 females) obese subjects, aged 9-15 y, were recruited. WERP required 2 y of follow-up. Body mass index (BMI) was evaluated at baseline and at each semester of follow-up. The obese subjects were subdivided into responsives and non-responsives, according to reduction or not of their BMI Z-scores during the WERP. Leptin concentrations were assayed at baseline and were included together with other independent variables in statistical multiple regression analysis.

RESULTS

At a preliminary multiple regression analysis, a significant positive correlation between leptin values and BMI Z-score reduction at the second, third and fourth semester of follow-up was registered. To determine the odds ratio of the subjects who were responsive or non-responsive at the various semesters of WERP follow-up, a stepwise logistic regression was used incorporating the same predictors, with the serum leptin values subdivided into quintiles and responsiveness and non-responsiveness as a binary outcome variable. The model offered a satisfying goodness of fit as shown by the sensitivity and specificity. The odds ratio of being responsive were significantly increased by greater quintiles of leptin serum concentrations. Furthermore, such odds ratios were much higher in pubertal than in prepubertal subjects.

CONCLUSIONS

These findings support a significant role for serum leptin concentration in predicting BMI changes as a response to an educational excess weight reduction program.

Open-sea migration of magnetically disturbed sea turtles

Green turtles (Chelonia mydas) that shuttle between their Brazilian feeding grounds and nesting beaches at Ascension Island in the middle of the Atlantic Ocean are a paradigmatic case of long-distance oceanic migrants. It has been suggested that they calculate their position and the direction of their target areas by using the inclination and intensity of the earth's magnetic field. To test this hypothesis, we tracked, by satellite, green turtles during their postnesting migration from Ascension Island to the Brazilian coast more than 2000 km away. Seven turtles were each fitted with six powerful static magnets attached in such a way as to produce variable artificial fields around the turtle that made reliance on a geomagnetic map impossible. The reconstructed courses were very similar to those of eight turtles without magnets that were tracked over the same period and in the previous year, and no differences between magnetically disrupted and untreated turtles were found as regards navigational performance and course straightness. These findings show that magnetic cues are not essential to turtles making the return trip to the Brazilian coast. The navigational mechanisms used by these turtles remain enigmatic.

Exposure to a hypogeomagnetic field or to oscillating magnetic fields similarly reduce stress-induced analgesia in C57 male mice

Previous studies have shown that exposure to altered magnetic fields alters analgesic responses in a variety of species, including humans. Here we examined whether deprivation of the normally occurring geomagnetic field also affects stress-induced analgesia, by measuring the nociceptive responses of C57 male mice that were restraint-stressed in a hypogeomagnetic environment (inside a mu-metal box). Stress-induced analgesia was significantly suppressed in a manner comparable to that observed in mice that were either exposed to altered oscillating magnetic fields or treated with the prototypic opiate antagonist naloxone. These results represent the first piece of evidence that a period in a hypogeomagnetic environment inhibits stress-induced analgesia.

The navigational feats of green sea turtles migrating from Ascension Island investigated by satellite telemetry

Previous tagging studies of the movements of green turtles (Chelonia mydas) nesting at Ascension Island have shown that they shuttle between this remote target in the Atlantic Ocean and their feeding grounds on the Brazilian coast, a distance of 2300 km or more. Since a knowledge of sea turtle migration routes might allow inferences on the still unknown navigational mechanisms of marine animals, we tracked the postnesting migration of six green turtle females from Ascension Island to Brazil. Five of them reached the proximity of the easternmost stretch of the Brazilian coast, covering 1777-2342 km in 33-47 days. Their courses were impressively similar for the first 1000 km, with three turtles tracked over different dates following indistinguishable paths for the first 300 km. Only the sixth turtle made some relatively short trips in different directions around Ascension. The tracks show that turtles (i) are able to maintain straight courses over long distances in the open sea; (ii) may perform exploratory movements in different directions; (iii) appropriately correct their course during the journey according to external information; and (iv) initially keep the same direction as the west-south-westerly flowing current, possibly guided by chemical cues.

Fasting serum leptin levels in the analysis of body mass index cut-off values: are they useful for overweight screening in children and adolescents? A school population-based survey in three provinces of central Italy

OBJECTIVE

Body mass index (BMI) was determined in a population of school students from three provinces of central Italy. Fasting serum leptin concentrations were assayed in a large number of subjects from the same area, to determine their distribution as plotted against the standard deviation score (z-score) of BMI.

DESIGN, SUBJECTS AND MEASUREMENTS

Height and weight were recorded from 31170 subjects (16175 male and 14995 female), aged 3-18 y, to construct BMI charts of children and adolescents from central Italy. Percentiles and z-score were calculated using the LMS method of Cole. Serum leptin concentrations were assayed in 1929 subjects (996 male and 933 female) after overnight fasting.

RESULTS

BMI percentiles of central Italy were higher than those from standards of other European and USA populations. When plotted against the z-score of BMI, serum leptin values were distributed according to an exponential curve, showing a steep pattern and a wide distribution, as BMI values increased. The hypothesis of the existence of two subgroups, based on a different relation between leptin and BMI, was verified and a separation point between the two subgroups was identified using cluster analysis, discriminant analysis and a novel method developed by our group, hereafter referred to as 'regression clustering'. This method allows identification of the value of the independent variable (z-score of BMI) which can be taken as a separation point. This analysis provided the best results and indicated the following separation points: central Italy standard, z-score = 0.72 (76.4th percentile) for males and z-score = 0.69 (75.5th percentile) for females; French standard (the one suggested for a European population by the European Childhood Obesity Group, ECOG), z-score = 1.46 (92.8th percentile) for males and z-score = 1.96 (97.5th percentile) for females. Similar but variable results were obtained when the same analysis was performed on serum leptin concentration, subdivided according to pubertal development (stage I, stage II-III, stage IV-V).

CONCLUSIONS

Children and adolescents from central Italy had greater BMI percentiles when compared to other European populations. Fasting serum leptin concentrations showed a distribution pattern related to z-score, thus allowing to identification of two different subgroups. The z-scores of BMI, identified as separation points, indicated a trend to leptin production by adipocytes that could be taken as indicators of significant increases of fat mass. This study proposes criteria and a statistical approach that could be useful in the identification of BMI cut-off values when screening children and adolescents for overweight.

Do geomagnetic disturbances of solar origin affect arterial blood pressure?

OBJECTIVE

Episodic reports suggest that geomagnetic disturbances of solar origin are associated with biological and clinical events, including increased arterial blood pressure (BP). We reassessed this aspect by relating solar activity levels to ambulatory BP measured in our out-patient population.

PATIENTS AND METHODS

The ambulatory BP measurements of 447 consecutive untreated patients attending a hypertension out-patient clinic who did a monitoring for diagnostic purposes over 5 years were retrieved. The mean daytime, night-time and 24-h BP and heart rate values were related to the temporally corresponding geomagnetic index k-sum obtained by the nearest observatory. K-sum is a local measurement of the irregular disturbances of the geomagnetic field caused by solar particle radiation.

RESULTS

Significant to highly significant positive correlations were observed for k-sum with systolic (daytime and 24 h) and diastolic BP (daytime, night-time and 24 h), but not with heart rate. No correlations were found with the k-sum of 1 or 2 days before the monitorings. Multiple correlations which also included other potential confounding factors (date, age) confirmed a significant effect of k-sum on BP. Comparison made in season-matched subgroups of quiet and disturbed days (using three different criteria of definition), always showed significantly higher values in the disturbed days for all BP parameters except systolic night-time pressure. The difference between the quietest and the most disturbed days was of about 6 to 8 mm Hg for 24-h systolic and diastolic BP.

CONCLUSION

These results are unlikely to be due to unrelated secular trends, but seem to reflect a real relation between magnetic field disturbances and BP.

Reduction of renal functional reserve in kidney transplant recipients: a possible role of arachidonic acid metabolism alterations

AIM

Renal functional reserve (RFR), resulting from an increase in glomerular filtration (GFR) after protein load, is a matter of debate. In kidney transplant recipients most studies have failed to show conclusive results, reporting either the absence, the reduction or the presence of renal reserve in normo-functioning kidneys. The aim of this study was to investigate RFR in kidney transplant patients as well as the possible hormonal vasoactive alterations underlying the reduction of renal reserve reported in some patients.

PATIENTS AND METHODS

We studied 8 controls and 25 patients, the latter with no history of acute rejection for at least 12 months and GFR >50 ml/min. The 25 patients were divided into 2 groups based on the presence (10) or the absence (15) of RFR.

RESULTS

Both the RFR group and the controls experienced a similar increase of GFR after oral protein load: 24.3 +/- 15.57% vs 24.4 +/- 10.8%. The group without RFR showed a paradoxical reduction of GFR after oral protein load: 13.3 +/- 13.2% (p <0.001). We analyzed the filtration fraction (FF) and observed that the group without RFR had higher values than the group with RFR and the controls: 0.35 +/- 0.11 vs 0.29 +/- 0.07 (p = 0.01) and vs 0.26 +/- 0.02 (p = 0.04). The hyperfiltration state observed in the group without RFR was sustained by a high level of thromboxane. The urine ratio TxB2/6ketoPgF1alpha was higher in the group without RFR than in the RFR group 0.78 +/- 0.2 vs 0.64 +/- 0.1 (p = 0.01). This ratio decreased only in the RFR group after a meat meal. In all the patients, changes of TxB2/6ketoPGF1alpha were inversely correlated to changes of GFR after a meat meal (r = -0.6, p = 0.01).

CONCLUSIONS

In conclusion, these data demonstrate that kidney transplant recipients with good organ function can be grouped according to the presence of RFR. RFR appears to be inversely correlated with the TxB2/6ketoPGF1alpha ratio, and its decrease seems to be linked to the failure of thromboxane to decrease and prostacycline to increase after a meat meal.

Leptin serum levels in normal weight and obese children and adolescents: relationship with age, sex, pubertal development, body mass index and insulin

OBJECTIVE

Leptin, the product of the ob gene, is present in higher concentrations in blood of obese subjects than of lean subjects. There is scarce information on the role of leptin in the pathogenesis of human obesity and little is known about leptin serum levels in obese children.

DESIGN, SUBJECTS AND MEASUREMENTS

To evaluate the influences of age, sex, pubertal development and weight excess on serum leptin levels, we have studied 390 obese subjects (OS) and 320 normal weight subjects (NWS) aged 5-16 y. Fasting insulin concentrations were assayed in NWS, and an oral glucose tolerance test was carried out in OS and total insulin area under the curve (TIA) was calculated.

RESULTS

Log-transformed values of leptin serum concentrations appeared to be distributed according to an acceptable Gaussian pattern. As observed in adults, serum leptin concentrations in children and adolescents were also increased (4-5 times) in OS as compared to NWS. In both males and females, subdivided according to pubertal stages, serum leptin varied significantly in stage IV-V as compared to the lower stages, with a reduction in males and an increase in females. On comparing the two sexes, greater serum leptin concentrations were observed in females of both NWS and OS. A significant linear correlation was found in both groups, subdivided according to sex and pubertal stage, between log values of serum leptin and standard deviation scores (SDS) of body mass index (BMI), and log-transformed relative body weight (RBW). Using partial correlation analysis in subjects subdivided according to sex and pubertal stages, log values of serum leptin and fasting insulin values, adjusted by age and SDS of BMI, correlated significantly with a weaker correlation in males than in females. In OS, the leptin concentrations correlated better with TIA than with fasting insulin. A weight reduction program (WRP) was carried out in 141 OS and significant reductions of serum leptin and fasting insulin were observed, showing a reduction of RBW. There was a correlation between the reduction of RBW and of serum leptin, but not of fasting insulin. No variation was found in non-responsive OS. RBW reduction correlated with leptin, but not with insulin (fasting and TIA), evaluated before the therapeutic program started.

CONCLUSION

As observed in adults, obese children and adolescents have higher serum leptin concentrations. However, several conditions should be taken into account when evaluating leptin concentrations in children. There are differences, independent of BMI, relative to pubertal stage and sex, females having greater leptin concentrations than males. There is evidence of a possible role for leptin in the effectiveness of a weight reduction program in OS.

Changes in pain perception and pain-related somatosensory evoked potentials in humans produced by exposure to oscillating magnetic fields

Nociception has been reported to be influenced by exposure to magnetic fields (MFs). The aim of this study was to investigate the effects of 2 h exposure to weak, oscillating MFs on pain perception thresholds and on pain-related somatosensory evoked potentials (SEPs). In 11 healthy volunteers, pain perception thresholds and pain-related SEPs were assessed by intracutaneous electrical stimulation. After sham treatment, pain thresholds significantly increased, whereas after MFs a slight non-significant decrease in thresholds was found. After both treatments pain-related SEP amplitude was reduced, but this decrease was more evident and statistically significant only after MF exposure. The increase found in thresholds after sham exposure may be due to stress-induced analgesia (SIA) and the contrasting behaviour recorded after MF exposure might indicate a suppression of SIA. The significant reduction in pain-related SEP amplitude observed after MF exposure provides the first evidence that human SEPs are influenced by MFs.

Serum levels of type I procollagen C-terminal propeptide, insulin-like growth factor-I (IGF-I), and IGF binding protein-3 in obese children and adolescents: relationship to gender, pubertal development, growth, insulin, and nutritional status

We measured fasting serum levels of type I procollagen C-terminal propeptide (PICP), insulin-like growth factor-I (IGF-I), and IGF binding protein-3 (IGFBP-3) in obese children and adolescents (obese subjects [OS]) to evaluate their relationship to growth, gender, pubertal stage, and weight excess (WE). The influence of insulin, growth hormone (GH), and weight loss was also studied. The study population consisted of 244 OS and 236 normal-weight subjects (NWS) matched for age, gender, and pubertal stage. At stage I, OS had a higher standard deviation score (SDS) for height than NWS of both genders. During the prepubertal phase, growth velocity (GV) was greater in OS than in NWS of both genders, but it was lower in female OS at stage II and male OS at stage III. PICP increased in puberty, with a more rapid decrease later in female OS and NWS; prepubertal values were higher in OS but were reduced at pubertal stage IV to V in comparison to NWS. Stepwise multiple regression analysis demonstrated that GV was the only anthropological variable correlating with PICP. IGF-I serum values increased significantly in puberty and were higher in OS than in NWS at stage I for both genders. IGFBP-3 values of OS exceeded those of NWS at stages I to III in males and I to II in females. No difference was observed for males versus females in each group, nor was any difference observed for the IGF-I/IGFBP-3 molar ratio between the two groups. Using stepwise analysis, a positive correlation between IGF-1 and IGFBP-3 was observed in prepubertal but not in pubertal NWS. Fasting insulin values correlated with IGFBP-3 in OS, accounting for 24.8% of the variation in prepubertal subjects and 17.1% in pubertal subjects. No such correlation was observed in NWS. In prepubertal NWS, PICP and SDS of body mass index (BMI) correlated with IGF-I, accounting for 12.9% of the variation, and SDS of BMI correlated with IGFBP-3, explaining 27.8% of the variation. In prepubertal OS, no such correlations could be observed, but PICP and SDS of BMI accounted for 14.3% of the variation in the IGF-I/IGFBP-3 molar ratio. A significant reduction of IGFBP-3 and an increase of the IGF-I/IGFBP-3 molar ratio were detected after weight loss in 40 OS. In conclusion, we demonstrated that IGF-I and IGFBP-3 are influenced by age, gender, sexual development, and nutritional status. Also, an influence of insulin on IGFBP-3 serum levels was observed in OS. The relations of IGF-I to PICP in NWS and of the IGF-I/IGFBP-3 molar ratio to PICP in OS support the concept of IGF-I influence on skeletal growth. The increased IGFBP-3 serum values in OS suggest a possible role in controlling the growth stimulus induced by nutritional status.

Pinpointing 'Isla Meta': the case of sea turtles and albatrosses

Satellite tracking has recently shown that the very long open-sea journeys of sea turtles and albatrosses share several features, in spite of the different physiological and environmental constraints to which turtles and birds are subjected. The reviews of data obtained by tracking migration and feeding routes show that both sea turtles and albatrosses are able (i) to pinpoint small, isolated targets by following straight courses, (ii) to continue on a bearing at night even when the moon is not visible, (iii) to compensate for wind or current drift and (iv) to return home after experimental, long-distance displacements. Sea turtles and albatrosses seem to rely on a position-fixing capacity which cannot be explained by known navigational mechanisms but might be shared by other animals that display similar feats of open-sea guidance. Future research will further benefit from satellite telemetry and other new techniques applied to experimental investigations.

Exposure to oscillating magnetic fields influences sensitivity to electrical stimuli. II. Experiments on humans

To assess the effect of a magnetic treatment on pain perception, we compared the sensory threshold in 18 healthy volunteers. We determined the threshold by noninvasive electrical stimulation of the tooth pulp and skin before and after exposure to an altered magnetic field of low intensity and to a sham treatment. Five different parameters were recorded: the sensory and pain thresholds for the tooth and the sensory, pain, and tolerance thresholds for the skin. Two hours of exposure to a weak, oscillating magnetic fields induced a significant decrease in three parameters (dental sensory and cutaneous pain and tolerance thresholds), whereas the other two parameters showed a similar tendency. When the same subjects were exposed to a sham treatment, only marginal, nonsignificant variations in all parameters were observed. These results represent the first piece of evidence that weak alterations of the magnetic field may induce hyperalgesia in humans.

Exposure to oscillating magnetic fields influences sensitivity to electrical stimuli. I. Experiments on pigeons

The comparison of two measurements of the pigeon threshold for electrical stimuli, performed 2 h apart, reveals stress-induced analgesia as a result of stressful manipulations between the two tests. When pigeons are exposed to a weak, oscillating magnetic field between the two measurements, the analgesic response is inhibited and a hyperalgesic effect is recorded. The present findings are in agreement with previous studies showing that magnetic treatments may alter pigeons' emotional state and some of their behavioral patterns.

Pigeons with ablated pyriform cortex home from familiar but not from unfamiliar sites

Homing behavior was tested in pigeons (Columba livia) after removing a portion of the ventrolateral telencephalon, which receives extensive projections from the olfactory bulb and is comparable with the mammalian pyriform cortex. Ablated pigeons show unaffected cardiac responses to odorous stimuli but altered homing behavior. After the operation, the birds were trained by repeated flock releases along with control birds from a site 40 km from the loft. After being released singly from this familiar site, the ablated birds turned out to be unaffected by the operation. In releases from two unfamiliar sites, ablated birds, unlike control birds, were not homeward oriented and were mostly lost. The ablation of the pyriform cortex has the same effect on homing behavior as olfactory deprivation. It can be concluded that the pyriform cortex plays an important role in the specific mechanisms linking olfactory inputs with the navigational response.

Olfactory bulb size, odor discrimination and magnetic insensitivity in hummingbirds

Relative olfactory bulb size with respect to telencephalic hemispheres (olfactory ratio) was measured in five species of hummingbirds. Trochiliformes were found to be next to last among 25 avian orders with respect to olfactory bulb development. One hummingbird species, the White-vented Violetear (Colibri serrirostris), was trained in a successive go/no-go discrimination task, and learned to feed or not to feed from a container dependent on the olfactory stimuli associated with it. Test birds learned to discriminate amyl acetate vs. turpentine essence, jasmine essence vs. lavender essence, eucalyptus essence vs. no odor, beta-ionone vs. no odor, carvone vs. eucalyptol. In contrast, 1-phenylethanol vs. beta-ionone discrimination, two odorants which appear similar to humans, was unsuccessful. Using a similar procedure, attempts were made to condition a White-vented Violetear and a Versicolored Emerald (Amazilia versicolor) to magnetic stimuli. The birds were unable to discriminate between a normal field and an oscillating field (square wave, 1 Hz, amplitude +/- 0.40 G).

Bone metaplasia (bone lithiasis) in a papillary transitional carcinoma of renal pelvis

A case of bone stone in association with a papillary transitional cell carcinoma of the renal pelvis is reported. This type of lithiasis, actually representing bone metaplasia, is rare in the urinary tract and has never been reported in true epithelial urinary tumors.

[The use of prostheses in recurrent hernias]

The use of inert plastic (Prolene mesh, 0,027 inches in thickness fournited by Ethicon) as preperitoneal prosthesis in repair of incisional hernias and inguinal hernia recurrencies has been investigated in 28 patients operated upon then 1977 to 1984. In 9 patients the inguinal approach was used with one recurrence (11%). In 9 patients the posterior approach through a midline incision has been used with two recurrences (22%). In 10 patients with incisional hernias there was only one recurrence (10%). Total recurrences rate was 14%. Most recurrences occur in patients operated from 1977 to 1980 (40%). Patients operated in the last period from 1980 to 1984 had no recurrences.

[The use of mechanical suturing in esophago-jejunal anastomoses]

10 esophagojejunostomies by EEA Stapler were performed on adult patients (8 males and 2 females, mean age 54 years), after total gastrectomy for gastric cancer. No postoperative bleeding or stricture were observed. 2 anastomotic leaks occurred (20%). The major cause of anastomotic failure is probably technical (incorrect assembly or lubrication of the instrument). According to the our experience and to literary data, the use of stapling devices for performance of esophagojejunostomies is recommended.

[Anal sphincter function following colorectal anastomosis with a stapler by transperineal-sphincter approach]

In 4 patients who under went low anterior resection for cancer of mid and lower 1/3 of the rectum, with colo-rectal anastomosis by posterior transphinteric approach, anorectal pressure profiles have been studied by open tip technique 30 d. 6 months following operation. Bowel movements, gas and feces discrimination and anal continence were also controlled. Resting pressure, delta % pressure changes during recto-anal reflex, pressure in voluntary contraction, altered in the first post-operative period, become normal in 6 months. Although volume and pressure at urgent rectal sensation, volume and rectal sensation and compliance altered after surgery did not change after 6 months, suggesting that the reservoir function of the rectum is lost, patients achieved a good control of bowel movements, and a good gas and feces discrimination and anal continence within the first 6 months of operation.

[The use of mechanical suturing in colorectal anastomoses]

In 16 patients affected by cancer of the mild or lower 3 of the rectum, has been performed a colorectal anastomosis by EEA Stapler, with abdomino-transanal approach. In the postoperative period no case of anastomotic bleeding or stenosis has been observed. 3 patients (18%) presented minor anastomotic dehiscence detected by radiologic examination, without clinical symptomatology. The EEA Stapler anastomosis seem sure almost as the traditional hand sutures, and allow the execution of anterior resection instead of abdominal perineal amputation of rectum.

[Strain-gauge plethysmography in the evaluation of the evolution of deep vein thrombosis of the legs]

Previous research has shown that MVO (Maximum Venous Outflow), VR (Venous Reflux), VE (Venous Emptying) and the respiratory waves recording are useful in differentiating occlusion and recanalization in postphlebitic syndrome. In the present work strain-gauge plethysmography was employed to quantitate the venous function after deep venous thrombosis of the legs. The studies were performed in a vascular laboratory with controlled temperature (23 to 25 C); records were obtained by a plethysmograph Parks mod. 270 connected to a Hewlett-Packard multi-channel mod. 7700. 17 patients (12 males, 5 females), mean age 55 years (range 24-75) that presented femoropopliteal thrombophlebitis documented by phlebography at the admission to the hospital were examined. MVO with and without superficial veins occlusion was measured by a mercury in silastic strain-gauge placed circumferentially about the calf. A pneumatic cuff thigh was inflated to 60 mm Hg. VE was measured in patients lying in inclined bed with the lower extremities 100 cm below the heart level compressing the calf with a pneumatic cuff 10 times for 5 seconds; the strain-gauge was placed on the foot level. VR after Valsalva's maneuver and the respiratory waves were recorded by a strain-gauge positioned at the maximum girth about the calf in patients lying on inclinated bed with the lower extremities 50 cm below the heart level. The result are here indicated: (Table: see text) There was differences in the evolution of venous function after deep venous thrombosis of the legs for each patient. Strain-gauge plethysmography may become evaluable non invasive technique in the evaluation of deep venous thrombosis evolution in the legs. The therapeutic assessment of postphlebitic syndrome.