The occurrence of diversion colitis in patients with a sigmoid neovagina

Diversion colitis is an inflammatory process occurring in segments of the colorectum surgically diverted from the fecal stream. Clinical symptoms of this condition are rectal discomfort, pain, discharge, and bleeding. We diverted isolated segments of sigmoid to create neovaginas in patients with aplasia vaginae and in male to female transsexuals. In contrast to what is reported in most studies of diversion colitis, the neovagina consists of an isolated segment not connected to the anus in patients without any pre-existing bowel disease. To investigate the occurrence of diversion colitis in these sigmoid-neovaginas we studied biopsy specimens from 13 patients. Most of the patients complained of discharge and slight blood loss from their sigmoid-neovagina. Microscopic examination of the biopsy specimens showed lymphocytic infiltration in all cases. Four cases showed an acute inflammatory infiltrate in the lamina propria. Our results indicate that the changes observed on clinical and histopathologic examinations represent the entity of mild diversion colitis. We conclude that diversion colitis also occurs in a sigmoid neovagina

Artificial Adaptive Systems and predictive medicine: a revolutionary paradigm shift

An individual patient is not the average representative of the population. Rather he or she is a person with unique characteristics. An intervention may be effective for a population but not necessarily for the individual patient. The recommendation of a guideline may not be right for a particular patient because it is not what he or she wants, and implementing the recommendation will not necessarily mean a favourable outcome

Infrared spectra of carbon monoxide on platinum, iridium and copper ; comparison of flat and rough surfaces

The IR Spectra of carbon monoxide adsorbed on different forms of platinum, iridium and copper (flat and rough surfaces) have been investigated. The results of IR transmission experiments on the silica supported metals are presented and compared with the data from IRAS (IR reflection adsorption spectroscopy) experiments on the unsupported metals. It is shown that the coverage dependency of the IR band frequency ΔνCO (θ) is independent of the state of the metal if the formation of islands of CO is taken into consideration. This was proven by isotopic dilution experiments with12CO/13CO mixtures. It is suggested that many apparent discrepancies and irreproducibilities in the literature can be explained by an uncontrolled formation of islands. At a given surface coverage. Group VIII metals reveal a lower νco value when CO is adsorbed on rough surfaces (or small particles) than on smooth surfaces (or large particles). The reverse is true for the lb metal Cu. The differences between supported and unsupported metals can be ascribed to differences in the electronic and geometric structure of the surface. The differences between adsorption of CO on Group VIII and lb metals are discussed in terms of a difference in bonding of CO on these two groups of metals