Complications of laparoscopy.

Five years'' experience with the laparoscope raises doubts about its continued use for sterilization. As a diagnostic tool, however, it serves a useful function.     

Interhemispheric regulation of dopaminergic ascending systems.

There are previous evidences of biochemical and functional interhemispheric asymmetry for central dopaminergic systems. The purpose of the current study was to establish an evidence of the existence of mechanisms for interhemispheric regulation of dopaminergic systems. The initial hypothesis was that to compensate the spontaneous interhemispheric asymmetry, the brain side with lower dopamine (DA) concentration show a higher DA turnover. The ratio of metabolite/neurotransmitter was computed as an index of presynaptic turnover rate. Both striatum and hippocampus showed a DOPAC/DA index higher in the brain side with a lower DA concentration. In addition, we found an inverse relation between the interhemispheric index of DA and interhemispheric index of DA turnover. Taken together the present data provide evidence of an interhemispheric regulation for the DA-innervation of both striatum and hippocampus in normal unlesioned rats.     

Pitfalls in the diagnosis of leg pain.

Problems may confront the practitioner in the diagnosis of leg pain related to exercise. The diagnostic features of the history and the physical examination that will help to elucidate the various causes of leg pain are outlined in this article, and the necessity for re-examination of the patient after a period of exercise is stressed. In most patients the diagnosis can most easily be made by means of clinical methods, without recourse to special investigations.     

Oxpentifylline treatment of venous ulcers of the leg.

OBJECTIVE--To determine the effect of oxpentifylline on the healing of venous ulcers of the leg. DESIGN--Double blind, randomised, prospective, placebo controlled, parallel group study. SETTING--Four outpatient clinics treating leg ulcers in England and the Republic of Ireland. PATIENTS--80 Consecutive patients with clinical evidence of venous ulceration of the leg in whom appreciable arterial disease was excluded by the ratio of ankle to brachial systolic pressure being greater than 0.8. INTERVENTIONS--All patients received either oxpentifylline 400 mg three times a day by mouth or a matching placebo for six months (or until their reference ulcer healed if this occurred sooner) in addition to a locally standardised method of compression bandaging. MAIN OUTCOME MEASURES--The primary end point was complete healing of the reference ulcer within six months. The secondary end point was the change in the area of the ulcer over the six month observation period. RESULTS--Complete healing of the reference ulcer occurred in 23 of the 38 patients treated with oxpentifylline and in 12 of the 42 patients treated with a placebo. Life table analysis showed that the proportion of ulcers healed at six months was 64% in the group treated with oxpentifylline compared with 34% in the group treated with a placebo (log rank test chi 2 = 4.78, p = 0.03), which was significant (odds ratio = 1.81, 95% confidence interval 1.20 to 2.71). CONCLUSION--Oxpentifylline used in conjunction with compression bandaging improves the healing of venous ulcers of the leg.