Thoracoscopic vagectomy for recurrent peptic ulcer disease

Duodenal and marginal jejunal ulcers respond promptly to vagus section. When a prior gastric drainage procedure has been done, the approach of choice for these ulcers is vagectomy through the left chest. This report describes four patients who were subjected to thoracoscopic vagectomy and had prompt early benefit. A description of our technique is presented.

The accuracy of portable cholesterol analyzers in public screening programs

To determine the accuracy of portable cholesterol analyzers in public settings, four screening organizations were accompanied to cholesterol screenings where consenting participants completed the finger-stick procedure and provided a blood sample by venipuncture. The finger-stick values were compared later with the participants' blood cholesterol values obtained in a reference laboratory. The results indicated that only one of the organizations produced cholesterol measurements entirely within the acceptable range (+/- 14.2%), while the accuracy of the other three organizations ranged from 76.5% to 96.4%. Those finger-stick values that did not fall within the acceptable range tended to underestimate the laboratory cholesterol values. Additionally, classification of the persons screened based on the National Cholesterol Education Program risk categories indicated that the finger-stick values primarily tended to produce false-negative results. The variability of the results across organizations was caused partially by insufficient operator training. However, inadequate quality-control procedures for field settings and dilution of capillary blood by tissue fluid also may have contributed to the inaccurate finger-stick results.

Demography of penetrating cardiac trauma

All cases of penetrating cardiac trauma in 1985 and 1986 in Jefferson County, Alabama, where patients dying of penetrating trauma received autopsies, were retrospectively reviewed. All hospitals in the county plus the single coroner's office provided the records of the 72 patients comprising this study. Incidents occurred most often in the home or residence (70%) by a known assailant (83%) due to domestic/social disputes (73%). Frequency was greatest in the evening hours (73% between 6:00 PM and 3:00 AM), on weekends in spring and summer. Victims tended to be male (86%), black (72%), married (46%), blue collar workers (62%). There were 41 (57%) gunshot wounds, 3 (4%) shotgun wounds, and 28 (39%) stab wounds with an associated mortality rate of 97%, 100%, and 68%, respectively. Prehospital mortality rate (dead at the scene) was 54.2% (39/72), and death on arrival was 26.4% (19/72), for a combined pretreatment mortality rate of 80.6%. All patients who arrived with no vital signs died. Mortality appeared to be related to mechanism of injury, age, race, sex, vital signs on arrival, number and specific cardiac chambers injured, associated major vascular injury, hematocrit, and mode of transportation. Mortality was not related to caliber of weapon, ethanol level, transport time, time from arrival to operation, or transfusion requirements. There were only ten survivors (1 gunshot wound and 9 stab wounds), all of whom had ventricular injuries and no associated major vascular injuries. The ten survivors represented a 71.4% (10/14) salvage rate for those victims arriving with vital signs. Complications occurred in three patients. Hospitalization averaged 7.3 days in the survivors. Penetrating cardiac trauma remains a serious, socially linked disease with a high rate of mortality. Rapid transport, aggressive resuscitation and cardiorrhaphy remain the best treatment.

Community programs to enhance in-school anti-tobacco efforts

This article presents theoretical bases for the development of community-wide anti-tobacco programs to reinforce school-based programs, discusses the problems involved in translating these theoretical bases into practice, and suggests means for minimizing those problems. Spiral of silence theory, diffusion theory, and expectancy value theory are covered. Special attention is given to the importance of a community program based in and "belonging" to the community, the need for high visibility, maximum participation by community individuals and organizations, mechanisms for program self-perpetuation, and explicit and visible ties to school-based anti-tobacco programs.

The short-term effects of competition and rewards in an adolescent smoking prevention program

This study evaluated whether interventions involving competition and rewards would enhance a school-based educational curriculum on tobacco use. Written pre- and post-tests were used to assess the relevant knowledge of 1068 seventh grade students in three comparable communities. The students' smoking beliefs, intentions, and behavior were assessed by questionnaires before and after the educational unit. Students in two communities participated in interventions designed to enhance knowledge acquisition, social activism, and non-use of tobacco; students in one community served as controls. Students in competitive and control communities did not differ prior to intervention. The interventions influenced respondents' concern about their health and the health of their family and friends and increased the likelihood that they would associate smoking with maturity and short-term bad effects, regardless of their pre-intervention smoking behavior. Experimenters' and regular smokers' knowledge about smoking and its consequences, and concern about the amount of substance use in their town were increased by the competitions. The competitions were also more likely to reduce their intentions to smoke. The interventions did not affect smoking behavior. Fortunately, competition losers and winners were not differentially affected by the interventions.

Modification of activity level through biofeedback and operant conditioning

The biomotometer, an electronic device that simultaneously measures activity and provides auditory feedback to the subject, was used in combination with material reinforcers in two experiments attempting to modify activity level in children. In the first study the activity level of an 11-year-old highly active boy was decreased below mean baseline during conditioning in a classroom setting. His level of activity returned to baseline when feedback was withdrawn. In the second study, activity level of a 10-year-old hypoactive boy was increased over mean baseline level during conditioning in a free-play setting, and returned to slightly below baseline during five extinction trials. Results of these studies indicate that the biomotometer is a useful instrument for modification of activity level.

Prenatal effects of Ochratoxin A in hamsters

Pregnant golden hamsters were injected ip with 2.5-20 mg/kg ochratoxin A on one of gestation days 7-10. The largest dosages when given on day 7,8, or 9 increased prenatal mortality and on day 9 diminished fetal growth. Malformations, such as micrognathia, hydrocephalus, short tail, oligodactyly, syndactyly, cleft lip, micromelia, and heart defects occurred, but no skeletal malformations were noted. These results add to the prenatal effects of ochratoxin A previously reported in mouse, rat, and chicken embryos.