First evaluation of a year of ambulatory surgery in urology

Day surgery in urology is in full growth actually. The present report is based on our first 120 patients. Low post-operative complication rate, patients' satisfaction and economical savings are the main factors for the important increase in this type of surgery.     

Fertilization in vitro. A review over the medical indications and suggestion to unified guidelines for public fertility clinics in Denmark

Medical indications for in vitro fertilization and embryo transfer (IVF-ET) internationally and in Denmark are reviewed. Reports from large international centres document that tubal infertility, unexplained infertility, endometriosis and male infertility are equally good indications for IVF. Traditionally, tubal infertility has been the only medical indication qualifying for IVF treatment within the National Health Service in Denmark. Thus, in this country, couples with unexplained and male infertility and with endometriosis have to pay up to 25,000 D.Kr. per IVF-ET treatment in private fertility clinics. Since there is no scientific basis for this discrimination, it is urged that the present rules are changed, so that couples with unexplained and male infertility and endometriosis are also allowed IVF treatment free of charge in the public fertility clinics.     

Interobserver variation in the assessment of the sampling quality of cervical smears

The present study was carried out to investigate the biochemical and morphological changes in the liver after ligation of the hepatic artery (HA) in the presence and in the absence of extrahepatic cholestasis (EHC). The study was conducted on 100 rats divided into four groups of 25 animals each: group 1, sham operation; group 2, hepatic artery ligation (HAL); group 3, bile duct ligation (BDL); and group 4, HAL plus BDL. All animals were sacrificed 7 days after surgery when total bilirubin and fractions, alkaline phosphatase (AP), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured in serum and on the inner hepatocyte mitochondrial membrane (IHMM); the incidence of necrosis and the volume fractions of vessels, bile ducts and hepatocytes in the liver were also determined. HAL reduces the relative volumes of bile ducts, with no changes in levels of bilirubin and fractions, AP, ALT, AST and IHMM, but HAL associated with EHC reduces duct proliferation and the liver becomes more vulnerable to necrosis. In conclusion, the normal liver depends on HA flow and this dependence is more evident in the presence of EHC.     

Sexual dimorphism of circulating somatotropin, insulin-like growth factor I and II, insulin-like growth factor binding proteins, and insulin: relationships to growth rate and carcass characteristics in growing lambs

The effects of sex and age on patterns of circulating somatotropin (ST) concentration and plasma IGF-I, IGF-II, insulin, and IGF binding protein-3 (IGFBP-3) were studied in ram, wether, and ewe lambs (n = 7 or 8) sampled at mean ages of 81 (I1) and 158 d (I2). Between 81 and 158 d of age, rams grew more rapidly than wethers (P < .01), and wethers grew more rapidly than ewes (P < .01). The sex differences in growth were reflected in empty body weight at slaughter: rams > wethers > ewes (P < .05). Mean plasma ST concentrations, ST pulse amplitude, and integrated plasma ST concentrations were greater (P < .05) in rams than in ewes at I1 and I2. Characteristics of the ST plasma profile in wethers were generally intermediate between those of rams and ewes. The interpulse interval was greater in ewes than in wethers at I2. The IGF-I and IGFBP-3 concentrations were greater in rams than in ewes at both sampling times. Plasma IGF-II was greater in ewes than in rams at I2. Mean plasma ST was approximately two thirds less at I2 than at I1 regardless of sex. Mean plasma ST and IGF-I at both ages were positively correlated with growth. Mean plasma ST at I2 was negatively correlated with fatness at slaughter. Sex and age significantly affected patterns of circulating ST and concentrations of IGF-I and IGFBP-3 in prepubertal growing lambs, under conditions for which growth rates and composition were also sexually dimorphic.     

Mediastinal space-occupying lesion with reduced perfusion of the left lung. Thoracic aortic aneurysm with compression of the left pulmonary artery

CONTEXT: An increase in the recreational use of personal watercraft (PWC) raises concern about an increase in associated injuries on a national level. OBJECTIVE: To estimate the relative frequency, types of injury, and demographic features of persons injured while using PWC in the United States. DESIGN: Case series. SETTING: Emergency department (ED) visits to hospitals participating a national probability sample. PARTICIPANTS: All persons treated for PWC-related injury from January 1,1990, through December 31, 1995. RESULTS: An estimated 32954 persons (95% confidence interval [CI], 22919-42989) with PWC-related injuries were treated in US hospital EDs, of which 3.5% were hospitalized. Personal watercraft-related injuries have increased significantly from an estimated 2860 in 1990 to more than 12000 in 1995. During this period, the number of PWC in operation increased 3-fold from approximately 241500 in 1990 to an estimated 760000 in 1995. The most prevalent diagnoses were lacerations, contusions, and fractures. MAIN OUTCOME MEASURES: The estimated number and percentage of patients treated in EDs for PWC-related injuries, by year, age, sex, and the number and rate per 1000 of PWC in operation by year. CONCLUSIONS: Since 1990, there has been at least a 4-fold increase in injuries associated with an increase in the recreational use of PWC. The rate of ED-treated injuries related to PWC was about 8.5 times higher (95% CI, 8.2-8.8; 1992 data) than the rate of those from motorboats. Specific training and adult supervision is recommended for minors using PWC. Furthermore, medical practitioners should encourage personal flotation device use and other protection for their patients who are known water enthusiasts.