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AIM: Studies have demonstrated a relationship between lymph node (LN) yield and survival after colectomy for cancer. The impact of surgical technique on LN yield has not been well explored. METHOD: This is a retrospective study of right colectomy (RC) for cancer at a single institution from 2012 to 2014. Exclusion criteria were previous colectomy and emergent and palliative operations. All data were collected by chart review. Primary outcomes were LN yield and the LN to length of surgical specimen (LN-LSS) ratio. Multivariable mixed models were created with surgeon and pathologist as random effects. Sensitivity analyses were performed to exclude Stage IV cancers and to analyse groups on an 'as-treated' basis. RESULTS: We identified 181 open (O-RC), 163 laparoscopic (L-RC) and 119 robotic (R-RC) right colectomies. O-RC was more commonly performed in women with metastatic disease. The mean LN yield was 28, 29 and 34 in O-RC, L-RC and R-RC, respectively; the respective mean LN-LSS ratios were 0.83, 0.91 and 1.0. The R-RC approach produced a higher LN yield than the other approaches (P < 0.01), and a higher LN-LSS ratio than O-RC (P < 0.01). These findings were unchanged in sensitivity analyses. CONCLUSION: Robotic right colectomy improves LN yield and the LN-LSS ratio, which may reflect better mesocolic excision. The effect of these findings on survival requires further investigation.

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To determine the pathogenic role of chromosomes 11 and 17 in the carcinogenesis of human ovarian cancers, neo(R)-tagged chromosome 11 or 17 was transferred from cell lines A9H11 or A9H17, respectively, into the ovarian carcinoma cell line SKOV-3 using microcell-mediated chromosome transfer. The chromosome transfer was verified by polymerase chain reaction detection of the neo(R) gene, fluorescence in situ hybridization detection of an extra chromosome 11, and microsatellite polymorphism detection of an exogeneous chromosome 11. Five SKOV-3/A9H11 hybrids and five SKOV-3/A9H17 hybrid clones were generated. For the chromosome 11 transfer, complete suppression of tumorigenicity was observed in four clones, (11)9-8 and 11(H)7-2, 11(H)8-3, and 11(H)7-2, 100 days post implantation. For the chromosome 17 transfer, no complete suppression of tumorigenicity was observed. However, an increased latency period ranging from 25 to 49 days in contrast to 7 days for the SKOV-3 parental line, and a significant reduction in tumor size was observed. There was no correlation between the in vitro growth rate and the tumorigenicity or length of latency period. Our results demonstrate functionally that chromosome 11 may carry a tumor suppressor gene(s) while chromosome 17 may carry a tumor growth-inhibitor gene(s) for the ovarian carcinoma cell line, SKOV-3.

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A family of new microporous composite membranes that do not require post-immobilization blocking or quenching steps has been developed for diagnostic immunoassay applications. These membranes, Autobloc membranes, are shown to have low nonspecific binding of proteins. Immobilization of antibody or antigen to the membrane can be achieved either by covalent binding or by adsorption. The correlation between the initial immobilization capacity for IgG and the effective immobilization capacity of microporous membranes is discussed. The performance of Autobloc membranes is demonstrated by dot-enzyme-linked immunoassays in the flow-through mode with several commonly used enzyme-substrate systems and compared to the performance of other membranes. The advantages of using Autobloc membranes are suggested.

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Spirometric data from 1586 healthy children, who did not smoke, were analysed to examine the effects of overweight as measured by the body mass index (weight/height2) on lung function. Overweight (72 boys, 88 girls) was defined as on or above the 90th percentile weight for height. After having controlled for the confounding variables of height and age, there were positive partial correlations between body mass index and lung function in girls whose weight was normal, in overweight girls, and in boys whose weight was normal, but not in overweight boys. In contrast to adults, body mass index has a positive effect on lung function in girls, whatever their weight. No such correlation between body mass index and lung function was seen in overweight boys. The observations may be accounted for by distinct sex dependent patterns of fat distribution in children.

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The properties of body mass indices were evaluated in a cross sectional study of the weights and heights of 5016 Chinese boys and girls aged between 3 and 18 years. Of the indices examined (weight/height (W/H), weight/height2 (W/H2), weight/height3 (W/H3) and weight/heightp (W/Hp], W/Hp was the only one that consistently showed least correlation with height, and so could be regarded as the optimal body mass index by the criterion of independence of the index from height. The exponent 'p' of W/Hp is, however, highly dependent on age; the value increases steadily between the age of 3 and 7-9 years, and then varies considerably around puberty. Only the age specific exponent ensures a lack of correlation between body mass index (W/Hp) and height. Age specific W/Hp should therefore be used in intrapopulation studies of weight or problems associated with obesity in children. Interpopulation comparison of weight and adiposity by W/H, W/H2, or W/H3 may give misleading results because of their dependence on height. Our results also suggest that the conventional weight for height charts may not be accurate enough for clinical use.

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To evaluate the long-term effects of slow-release formulations of theophylline and terbutaline on pulmonary function, clinical symptoms, and side effects, 24 children with stable and moderately severe perennial asthma participated in a prospective double-blind cross-over study. The patients and the treatments were randomized according to the Latin square design to eliminate all possible period/climate biases throughout the protracted study period. The treatments consisted of terbutaline, 5 mg, theophylline, 200 mg, the combination, and placebo, given twice daily orally and crossing over every 28 days. The two drugs, administered alone or in combination, improved lung function and symptoms when compared with placebo. The interaction of theophylline and terbutaline was quantitatively shown by 2 x 2 factorial statistical design to be essentially additive rather than synergistic in the control of asthma. No increase in side effects was noted when the combined therapy was used. These findings suggest therapeutic advantages to combining submaximal oral doses of sustained-release theophylline and terbutaline for the long-term treatment of children with asthma.

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Five infants with persistent hypoglycaemia due to hyperinsulinism were reported. Provocative tests for insulin release were unhelpful. Diazoxide was useful in the treatment of three patients but many side-effects were observed. These included petechial rash, hypertrichosis, acute renal failure, fluid retention and cardiac failure. Two patients underwent spontaneous remission. Three patients had nesidioblastosis, two of whom were subjected to 95% pancreatectomy. Postoperatively, recurrence of hypoglycaemia was due to hyperinsulinism in one patient and to presumed glucagon deficiency in the other. Phenytoin effectively corrected the hypoglycaemia in the patient who had postoperative hyperinsulinism. It is recommended that medical therapy with diazoxide (10-15 mg/kg per day) together with a diuretic be commenced once hyperinsulinism is diagnosed. Subtotal pancreatectomy should be performed early in these patients if hypoglycaemia cannot be controlled with medical therapy or if side-effects of treatment are documented.

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Pulmonary function tests were evaluated in 28 Chinese patients with beta-thalassemia major receiving regular transfusions and desferoxamine, and in 34 height-matched normal Chinese children. Comparison of lung function using analysis of covariance with reference to standing height showed that patients with thalassemia had a proportional decrease in forced vital capacity and forced expiratory flow volume in 1 second, whereas their expiratory flow rates, residual volume, and total lung capacity were comparable to those in normal children. The single-breath carbon monoxide diffusion capacity was normal. Our findings suggest that children with thalassemia major have mild restrictive lung disease. The previous controversy regarding the presence of restrictive or obstructive lung disease in patients with thalassemia may be related to the use of inappropriate control values.

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A prospective randomised single-blind study of the effects of real and sham acupuncture on exercise-induced asthma was conducted in nineteen children. Forced expiratory flow in 1st second (FEV1), forced vital capacity (FVC), and peak expiratory flow rate (PEFR) were measured throughout acupuncture and after treadmill exercise. Neither real nor sham acupuncture affected the basal bronchomotor tone but both, when applied 20 min before exercise, attenuated exercise induced asthma: mean maximum percentage falls in FEV1, FVC, and PEFR were 44.4%, 33.3%, and 49.5% without acupuncture; 23.8%, 15.8%, and 25.9% after real acupuncture; and 32.6%, 26.1%, and 34.3% after sham acupuncture. Real acupuncture provided better protection against exercise-induced asthma than did sham acupuncture (p less than 0.05).

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