Questions of liability in unsuccessful voluntary sterilization (author's transl)

Since the June 29, 1976, decision of the Federal High Court of the Federal Republic of Germany, voluntary sterilization is permitted under certain, limited, circumstances. After the physician has thoroughly instructed the patient, the patient must give written consent in agreement with S 226 of the penal code. The physician cannot then later be charged with commiting bodily injury according to S 224 of the penal code. Recently, the German courts have tended more and more to consider the unplanned birth of a child following unsuccessful sterilization as a damage case for which the attending physician is held responsible under civil law. For most physicians, this means that the financial compensation set by the court is not, or at least not fully, covered by their medical indemnity insurance. A corresponding increase in the medical indemnity coverage or a release from all damage claims overagainst the attending physician signed by the patient is urgently indicated.     

Family interaction patterns and children's behavior problems from infancy to 4 years.

Employed a new naturalistic observational methodology to assess molar aspects of family interaction in 29 4-yr-old children and their mothers. The 4-yr-olds and their families had been followed since age 6 mo, and correlations between the early measures and the 4-yr measures were computed. Proactive maternal involvement, defined in terms of affectively positive, educative exchanges between mother and child, was strongly related concurrently to the relative absence of problem behavior in the 4-yr-old. Early displays of family coercion were predictive of behavior problem ratings at age 4, but not as strongly as the absence of early positive interactions. Temperamental difficultness in the first 2 years also predicted behavior problems at age 4. The age-4 observation measures correlated in a rich pattern with observation measures at ages 1 and 2. This suggests both continuity of family style and conceptual compatibility between the earlier recording system, based on molecular codes, and the current system, heavily based on written narratives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A measurement of liver volume and its changes in post-hepatitic cirrhosis

By use of the computerized digital image processing system, the liver volume in vivo was successfully measured and the three dimensional image of the liver rebuilt in 62 cases of posthepatitic cirrhosis and 15 noncirrhotics. It was found (1) The liver volume of 474.64 +/- 115.28cm3/m2 in Chinese cirrhotics is significantly smaller than that of the control (P < 0.001); (2) In most cases, patients in class I of the liver function have a larger liver volume; (3) Patients with smaller liver volume have poor tolerance to surgery with a critical value of 400cm3/m2; (4) the liver volume considerably reduced after shunt plus devascularization but did not change after devascularization only.     

Tubal selection for gamete intrafallopian transfer

When both fallopian tubes appear normal, tubal selection for GIFT is left to the surgeon's discretion. We were interested to learn whether pregnancy rates were influenced by the choice of tubal transfer in relation to ovarian dominance. Ovarian dominance was defined sonographically as the ovary containing the greater number of follicles having a mean diameter > 16 mm. In a retrospective analysis of 144 GIFT procedures, the clinical pregnancy rate for transfers performed to the tube ipsilateral to the dominant ovary was significantly higher than that of transfers made to the contralateral tube (0.414 versus 0.228, P = 0.042). This difference could not be attributed to either patient characteristics or cycle performance. We suggest that gamete transfer be performed ipsilateral to the side with the greater number of dominant follicles to optimize pregnancy rates.