Urticaria secondary to a copper intrauterine device

A 24-year-old woman developed in acute urticarial reaction secondary to a copper intrauterine contraceptive device. Allergy to copper was proven by scratch tests. The condition cleared with removal of the IUD.     

Experience with the locking nail (author''s transl)

Although difficult, recurrent forms of pterygium are seldom seen in central Europe, they cause considerable therapeutic problems because they cannot be cured by simple dissection and conjunctivoplasty. A useful method of treatment in these cases is the marginal, lamellar keratoplasty, which, according to the type of involvement, can take the shape of a sector, ring, horseshoe, or semicircle. If the pterygium is extensive and affects the center of the cornea, a subtotal, lamellar keratoplasty can be performed. The rate of recurrence in the group of 35 lamellar keratoplasties which we performed amounted to a satisfactory 31%. Only rarely did a pronounced astigmatism cause a decrease in the visual acuity postoperatively. Essential for the success of the procedures are exact surgical techniques and local use of atropine and cortison postoperatively. Just as with other surgical procedures, however, the lamellar keratoplasty cannot be considered the perfect method for all pterygiums.     

On Endocrine Hypothalamic Systems (authors transl)

The article summarizes under morphological aspects, the most important results of neuroendocrinology as far as hypothalamus and hypophysis are concerned.     

Experience with special-type pacemaker leads (author's transl)

The dislodgement rate of endocardially placed pacemaker leads can be decreased by the use of special-type electrodes. Since 1963 a total of 2100 pacemaker implantations was performed. Since 1970 we have been using special-type electrodes in 15 to 20% of our patients each year. The complication rate of all pacemaker leads implanted in the period 1974 to 1978 was 7.6%, the rate of the special type electrodes alone came up to 15%. The lead IE--65--I had the greatest deal of this - 11 out of 43 leads had to be removed. 152 electrodes type IVE--85--armed with metal hooks - were implanted, 18 of which had to be revised and 17 of 117 rigid leads type IE--60--KS--10 revealed failure which made revision necessary. In contrast, 54 screw-in leads type 6957, Medtronik and AE--60--YR, Biotronik caused only one perforation - a lethal one. Primary experiences with a porous tip lead (CPII--4116) are good enough to recommend the use of this electrode as a lead of first choice. We saw 2 dislodgements in 50 implantations. Failure to sense or to pace were never seen (time of observation 2 to 18 months).     

Cholelithiasis in children and adolescents (authors transl)

Cholelithiasis is a rare, but important condition to be considered in the differential diagnosis of abdominal symptoms in childhood and adolescence. A survey over a 20-year period revealed 10 cases between the ages of 11 and 20 years, with a clinical history of cholelithiasis of between 5 days and 6 years. The most consistent finding was epigastric or right upper quadrant pain. Serum chemistry did not contribute conclusively towards the diagnosis. Hereditary spherocytosis was demonstrated in 3 cases, 2 had familial gall bladder disease, whilst in the rest no cause could be found. Two patients are described in some detail: one girl with spherocytosis and a bilirubin of 78 mg/100 ml, presenting with choledochal obstruction and pancreatitis, and another girl with a history of recurrent abdominal pain, negative radiologial and chemical pathological findings and a tentative diagnosis of neurosis. Oral cholecystograms lead to the diagnosis in most cases; however i. v. cholangiograms should be considered whenever the diagnosis appears in doubt. All cases were treated by cholecystectomy and recovery was uneventful in 9 patients. Cholecystectomy should be performed in all patients with gall stones, even in the absence of symptoms.     

Clinical experience with the copper-7 intrauterine contraceptive device. A preliminary report

There have been 203 copper-7 IUD insertions performed in 199 women. The data from 2,230 woman-months of use have been analyzed and compared with other published reports. The copper-7 IUD was an acceptable contraceptive method in regard to effectiveness, continuation, and lack of serious complications.     

New intensifier screens in pediatric radiology (authors transl)

On the basis of the physical and clinical findings of this investigation, the characteristics of new screens made of rare earths were described. The possibilities of application for pediatric radiology and those advantages which can be achieved with the new screens were discussed. Possible technical difficulties were mentioned.     

Bilateral intrauterine torsion of the spermatic cord (case report) (author's transl)

A case of bilateral intrauterine torsion of the spermatic cord is reported. The possibility of an intrauterin origin is given by observations in newborn infants. The head symptoms are scrotal swelling, flush and induration. Already a suspected torsion of the spermatic cord justifies immediate surgery as the germinative and interstitial cells are irreversibly damaged after very short time. The obstetrician is obliged to diagnose these pre- or perinatally originated torsions and to arrange immediate surgery.     

Incidence of pelvic inflammatory disease in clinical trials with Cu-7 (intrauterine copper contraceptive): a statistical analysis

Pelvic inflammatory disease (PID) was recorded for 365 of 10,760 women using the Cu-7 for up to 48 months during clinical investigations in the United States. This involved a total exposure of 242,169 woman-months, or some 20,000 woman-years. The overall incidence of PID was 18 cases/1000 woman-years. Incidence was inversely related to age and to duration of use. It was statistically significantly greater in parous subjects than in nulliparous, after stratifying for age. The estimated rates in this study do not differ markedly from those in most other prospective investigations.     

The copper-7 intrauterine contraceptive device: 5-year evaluation

Over a 5-year period a family practitioner inserted copper-7 (Cu-7 intrauterine contraceptive devices (IUDs) in 134 women. The rates of continued use after 2 years, 53.0% for the women's first IUD and 63.9% for all their IUDs, and of accidental pregnancy, 2.4%, are comparable to those in the literature. However, in this series the rate of expulsion was 0.8%, much lower than that in the literature. Fertility did not appear to be reduced in women who planned to have pregnancies after the device was removed. A carefully scrutinized technique of insertion and conscientious follow-up make the Cu-7 IUD an acceptable form of contraception for many patients in a family practice.     

Experience with radio isotope myelography from neurosurgical aspects (author's transl)

Experience with Radio Isotope Myelography is reported here. 169Yb-DTPA as a tracer was intrathecally injected at lumbar region in twenty three patients with various spinal cord lesions. The first scanning is perfomed after comfirming by gamma-camera that the tracer reaches to the lesion, the second and the third scannings are done according to the ascending rate of the tracer. (I) Normal scintimyelogram (A) In normal case, the shape of the Radio Isotope Myelogram well corresponds the shape of anatomical subarachnoid space. (B) In normal adult cases, the tracer comes up to the cisterna magna in 20-25 minutes after the lumbar injection. Therefore, the scintimyelographic diagnosis should be made not only by the shape but also by the ascending rapidity of the tracer. (II) Abnormal scintimyelogram Abnormal scintimyelograms could be summarized as following three categories. (A) "Delay": It means delay of the ascending of the tracer. Besides, "Transient delay" found in a case of Arnord-Chiari's malformation was proposed. (B) "Partial block": It meas a defect at the level of the lesion. This "Partial block" were observed in cases of spinal cord angioma, cervical spondylosis and spinal cord tumor etc. (C) "Complete block": It means the stagnation of the tracer below the lesion. To sum up, Rario Isotope Myelography, especially in partial block, can more easily and more sensitively represent the maximum extent of the spinal cord lesion than other myelographic study or angiographic one. On the other hand, we can not qualitatively diagnose about the lesions by its indistinct border.