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Penicillin and natural immunity protect against post-splenectomy sepsis
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INTERNATIONAL ABSTRACTS
circulating vacuolated erythrocytes were carried out 1 and 3 months after splenectomy. The spleen scans were positive after 1 month and the isotope uptake increased after 3 months, demonstrating splenic phagocytic function. The number of vacuolated erythrocytes also indicated some restoration of the pitting function of the implanted splenic tissue. No alterations in serum immunoglobulins were seen, but a moderate thrombocytosis and monocytosis persisted for 3 months. Future improvements in the implantation procedure are discussed.--M. Agrawal Penicillin and Natural Immunity Protect Against Post-splenectomy Sepsis. C. D. Livingston, B. A. Levin and K. R.
torsion were identified by gross reductions in isotope uptake. Enhanced uptake (indicating hyperaemia) was seen in 37 patients with acute epididymitis, testicular tumour or resolved torsion. Late torsion and some tumours demonstrated a "halo" sign, with central necrosis and a peripheral increase in blood supply. A group of 22 patients with previous orchidopexy for torsion was reviewed 2 to 5 years postoperatively. In 15 the previously twisted testis was > 10% smaller than its opposite member, and 12 patients showed severe abnormalities of seminal analysis. Hormonal profiles were generally normal. Retention of testes damaged by ischaemia may impose a risk of autoimmunization against spermatogenesis.--L. Spitz
Sirinek. J Surg Res 24:332-336, (April), 1983. An animal model with bacterial introduction via the lungs was used to investigate the effect of penicillin and previous exposure to an infecting organism on the mortality of postsplenectomy sepsis. Twelve weeks after either a sham operation, intraperitoneal splenic autotransplantation, or splenectomy, 159 rats were challenged using Streptococcus pneumoniae delivered transtrachealy. Half of each group received procaine penicillin for 5 days beginning 24 hours postbacterial innoculation. Eight weeks later, surviving rats were reinnoculated with the same organism. Using this model, prior exposure to the same organism was shown to reduce mortality even in splenectomized animals. Furthermore, penicillin given 24 hours post-infection markedly reduced mortality in all groups including the splenectomized animals. The post-infection administration of penicillin not only protected all animals, but also provided more protection than either autotransplantation or previous exposure to the infecting organism. Therefore, the continued administration of antibiotics in the clinical setting, after splenectomy, seems to have a rational basis.--Richard R. Ricketts
The Results of Surgical Therapy for Bilateral Maldescended Testes. M. Schoorl, E. L. Frensdorf and J. P. G. Heijens. Z
Kinderchir 38:169-172, 1983. The authors report on a series of 305 boys treated for bilaterally maldescended testicles from 1937 to 1962. All patients had been operated on at age 11 to 12 years by identical operative techniques and by the same surgeon in 85% of the cases. One hundred and ninety patients were submitted to follow-up examination and 141 sperm analyses were obtained. Azoospermia was found in 25%, oligospermia in 55%, and normospermia in only 20%. Fertility rates were better in men with primarily ectopic testicles than in men with cryptorchidism. Out of 107 married men, 39 had one or more children (36%). One factor for these poor results is age; the trend of the last 10 to 15 years to operate on these children at a considerably younger age is strongly confirmed by these findings. Further long-term follow-up, however, are needed in order to compare the results of operations carried out at a much younger age and by different t e c h n i q u e s . Thomas A Angerpointner
Segmental Infarction of the Greater Omentum: A Cause of Acute Abdomen in Childhood. R. H. Rich and R. M. Filler.
Can J Surg 26:241-243, (May), 1983. Segmental infarction of the greater omentum is an unusual cause of acute abdominal pain in children. From 1951 to 1981, this entity was encountered nine times at the Hospital for Sick Children in Toronto. The patients ranged in age from 4 to 15 years. All presented with right lower quadrant pain. They were diagnosed as having acute appendicitis. At operation, the appendix was found to be normal and an area of infarcted omentum was identified as the cause of the acute symptoms. Torsion of the infarcted omentum was noted in four instances, but in the other cases, the etiology was obscure. Excision of the involved omentum was c u r a t i v e . Colin C. Ferguson
GENITOURINARY TRACT Diagnosis and Outcome of Testicular Torsion. IV. E. G.
Thomas and R. C. IV. Williamson. Br J Surg 70:213-216, 1983. In a prospective study of 80 patients with acute testicular pain, static and dynamic scans of the scrotum were obtained by radionuclide imaging. Seven patients with acute testicular
Location and Fate of The Nonpalpable Testis in Children.
M. J. Smolko, G. W. Kaplan, and W. A. Brock. J Urol 129:1204-1206, (June), 1983. The records of 261 children who were treated surgically for cryptorchidism between 1975 and 1980 were reviewed to determine the incidence, exact location, and results of treatment of nonpalpable testes. Of these 261 patients, 71 had 80 nonpalpable testes (27%). Of these 80 nonpalpable testes, 17 (21%) were determined to be absent at the time of thorough intra-abdominal and retroperitoneal exploration. O f the 63 testes found at surgical exploration, 34 (56%) were intraabdominal (intraperitoneal), 10 (16%) were in a preperitoneal position behind the internal inguinal ring, 15 (24%) were canalicular, and 4 (5%) were located in the superficial inguinal area. Seventeen (27%) testes were removed because of postpubertal age, testicular atrophy, or anatomic deformity inconsistent with an attempt at orchiopexy. In the remaining testes the success rate of orchiopexy was compared on the basis of the original anatomic location of the testis and the type of surgical procedure performed. Of those testes deemed suitable for orchiopexy, 89% in a preperitoneal or more distal location and 74% of intraperitoneal testes were placed successfully in the scrotum.--George Holcomb, Jr
INTERNATIONAL ABSTRACTS
circulating vacuolated erythrocytes were carried out 1 and 3 months after splenectomy. The spleen scans were positive after 1 month and the isotope uptake increased after 3 months, demonstrating splenic phagocytic function. The number of vacuolated erythrocytes also indicated some restoration of the pitting function of the implanted splenic tissue. No alterations in serum immunoglobulins were seen, but a moderate thrombocytosis and monocytosis persisted for 3 months. Future improvements in the implantation procedure are discussed.--M. Agrawal Penicillin and Natural Immunity Protect Against Post-splenectomy Sepsis. C. D. Livingston, B. A. Levin and K. R.
torsion were identified by gross reductions in isotope uptake. Enhanced uptake (indicating hyperaemia) was seen in 37 patients with acute epididymitis, testicular tumour or resolved torsion. Late torsion and some tumours demonstrated a "halo" sign, with central necrosis and a peripheral increase in blood supply. A group of 22 patients with previous orchidopexy for torsion was reviewed 2 to 5 years postoperatively. In 15 the previously twisted testis was > 10% smaller than its opposite member, and 12 patients showed severe abnormalities of seminal analysis. Hormonal profiles were generally normal. Retention of testes damaged by ischaemia may impose a risk of autoimmunization against spermatogenesis.--L. Spitz
Sirinek. J Surg Res 24:332-336, (April), 1983. An animal model with bacterial introduction via the lungs was used to investigate the effect of penicillin and previous exposure to an infecting organism on the mortality of postsplenectomy sepsis. Twelve weeks after either a sham operation, intraperitoneal splenic autotransplantation, or splenectomy, 159 rats were challenged using Streptococcus pneumoniae delivered transtrachealy. Half of each group received procaine penicillin for 5 days beginning 24 hours postbacterial innoculation. Eight weeks later, surviving rats were reinnoculated with the same organism. Using this model, prior exposure to the same organism was shown to reduce mortality even in splenectomized animals. Furthermore, penicillin given 24 hours post-infection markedly reduced mortality in all groups including the splenectomized animals. The post-infection administration of penicillin not only protected all animals, but also provided more protection than either autotransplantation or previous exposure to the infecting organism. Therefore, the continued administration of antibiotics in the clinical setting, after splenectomy, seems to have a rational basis.--Richard R. Ricketts
The Results of Surgical Therapy for Bilateral Maldescended Testes. M. Schoorl, E. L. Frensdorf and J. P. G. Heijens. Z
Kinderchir 38:169-172, 1983. The authors report on a series of 305 boys treated for bilaterally maldescended testicles from 1937 to 1962. All patients had been operated on at age 11 to 12 years by identical operative techniques and by the same surgeon in 85% of the cases. One hundred and ninety patients were submitted to follow-up examination and 141 sperm analyses were obtained. Azoospermia was found in 25%, oligospermia in 55%, and normospermia in only 20%. Fertility rates were better in men with primarily ectopic testicles than in men with cryptorchidism. Out of 107 married men, 39 had one or more children (36%). One factor for these poor results is age; the trend of the last 10 to 15 years to operate on these children at a considerably younger age is strongly confirmed by these findings. Further long-term follow-up, however, are needed in order to compare the results of operations carried out at a much younger age and by different t e c h n i q u e s . Thomas A Angerpointner
Segmental Infarction of the Greater Omentum: A Cause of Acute Abdomen in Childhood. R. H. Rich and R. M. Filler.
Can J Surg 26:241-243, (May), 1983. Segmental infarction of the greater omentum is an unusual cause of acute abdominal pain in children. From 1951 to 1981, this entity was encountered nine times at the Hospital for Sick Children in Toronto. The patients ranged in age from 4 to 15 years. All presented with right lower quadrant pain. They were diagnosed as having acute appendicitis. At operation, the appendix was found to be normal and an area of infarcted omentum was identified as the cause of the acute symptoms. Torsion of the infarcted omentum was noted in four instances, but in the other cases, the etiology was obscure. Excision of the involved omentum was c u r a t i v e . Colin C. Ferguson
GENITOURINARY TRACT Diagnosis and Outcome of Testicular Torsion. IV. E. G.
Thomas and R. C. IV. Williamson. Br J Surg 70:213-216, 1983. In a prospective study of 80 patients with acute testicular pain, static and dynamic scans of the scrotum were obtained by radionuclide imaging. Seven patients with acute testicular
Location and Fate of The Nonpalpable Testis in Children.
M. J. Smolko, G. W. Kaplan, and W. A. Brock. J Urol 129:1204-1206, (June), 1983. The records of 261 children who were treated surgically for cryptorchidism between 1975 and 1980 were reviewed to determine the incidence, exact location, and results of treatment of nonpalpable testes. Of these 261 patients, 71 had 80 nonpalpable testes (27%). Of these 80 nonpalpable testes, 17 (21%) were determined to be absent at the time of thorough intra-abdominal and retroperitoneal exploration. O f the 63 testes found at surgical exploration, 34 (56%) were intraabdominal (intraperitoneal), 10 (16%) were in a preperitoneal position behind the internal inguinal ring, 15 (24%) were canalicular, and 4 (5%) were located in the superficial inguinal area. Seventeen (27%) testes were removed because of postpubertal age, testicular atrophy, or anatomic deformity inconsistent with an attempt at orchiopexy. In the remaining testes the success rate of orchiopexy was compared on the basis of the original anatomic location of the testis and the type of surgical procedure performed. Of those testes deemed suitable for orchiopexy, 89% in a preperitoneal or more distal location and 74% of intraperitoneal testes were placed successfully in the scrotum.--George Holcomb, Jr