Evaluation of a new method for treating segmental renal disease.

Experimental segmental renal artery embolization was performed to evaluate the feasibility of therapeutic segmental renal embolization. In group 1, a two kidney dog model, segmental embolization of the right kidney was performed in ten dogs using Gelfoam, Silastic elastomer and barium sulfate. In group 2, a one kidney dog model, segmental embolization of left kidney was performed using Gelfoam and Silastic elastomer. In the remaining three dogs of group 2, embolization was not done for control. Sequential blood pressure measurements, plasma renin activities and renal arteriograms were obtained. Three dogs in group 2 died following unintentional complete renal embolization. Seventeen of the 18 dogs of the entire study remained normotensive after embolization. One dog had persistent hypertension develop which was controlled by a second, total renal embolization. The results suggest that therapeutic segmental renal embolization is a feasible method for treating segmental renal disease.     

A new method for assessment of fetal lung maturity.

A new method for evaluation of fetal lung maturity in utero is described. The method is based on the fluorescence polarization (P) of the lipids in the amniotic fluid after labelling with a special dye. Tests performed with 49 amniotic fluid samples drawn from 33 pregnancies clearly demonstrated a decrease in P during gestation which correlated with the increase in the lecithin/sphingomyelin ratio (L/S) in the fluid. During gestation the P value at 24 degrees C decreased steadily from about 0-4 to 0-2 and the value of P (24 degrees C) = 0-310 has been tentatively chosen as the threshold above which respiratory distress syndrome may develop. The described method, which requires a specially designed instrument, offers a series of important advantages over the presently available methods. It is simple, rapid, highly accurate and reproducible, and independent of amniotic fluid volume. The P value reflects the microviscosity in the whole lipid assembly of amniotic fluid and is not confined specifically to lecithin.     

A new method for intrauterine insemination

The women from 60 couples, suffering from subfertile semen, poor postcoital tests, the presence of antipsermal antibodies in the females' vaginal mucus or in the males' semen, or unexplained fertility of more than 5 years duration, were administered artificial insemination. The 5 cm long endpiece of a soft Nelaton's catheter, size 6-8, splinted with a rigid polyethylene cannula was used. Pregnancy occurred in 17 of the cases (28%). Best results were obtained in those couples who had shown unexplained infertility for more than 5 years and in the group with poor postcoital tests. Good results were shown from in vitro sperm penetration tests. Complications were infrequent. The introduction of this catheter did not elicit sperm agglutininsin the female. However, if sperm agglutinins were already present, the titer level of these antibodies increased after the procedure, leading to failure of the insemination in most cases. Nevertheless, this method is considered useful in cases of a hostile uterine environment or insufficient spermatozoids.     

A new method for nonsurgical cholecystolithotomy

A new method of nonsurgical removal of gallbladder stones is presented herein. The method consists of two parts: a, ultrasonically guided percutaneous transhepatic gallbladder drainage, and b, extraction of gallbladder stones using a choledochofiberscopic maneuver. The procedure is safe, less stressful than a surgical procedure and easy to perform. The method is useful for extremely ill or elderly patients and those who prefer not to undergo surgical treatment.     

Laparoscopic bipolar coagulation of uterine vessels: a new method for treating symptomatic fibroids

OBJECTIVE: To evaluate the effects of laparoscopic bipolar coagulation of uterine vessels in treating symptomatic fibroids. DESIGN: Prospective clinical study. SETTING: University-affiliated tertiary referral center. PATIENT(S): Eighty-seven women with symptomatic fibroids warranting surgical treatment and wanting to retain their uteri. INTERVENTION(S): Laparoscopic bipolar coagulation of uterine arteries and anastomotic sites of uterine arteries with ovarian arteries. MAIN OUTCOME MEASURE(S): Percentage reduction in the dominant fibroid size and clinical response evaluation. RESULT(S): Eighty-five (97.7%) of 87 patients underwent technically successful laparoscopic coagulation of uterine vessels without intraoperative complications. The mean follow-up time was 10.2 months. Symptomatic improvement was reported in 76 (89.4%) of 85 patients, including 18 (21.2%) with complete resolution of symptoms. Significant reductions in the dominant fibroid size (average, 76%) and the uterine volume (average, 46%) were sonographically demonstrated. Two patients conceived 4 and 9 months, respectively, after treatment. Three (3.5%) premenopausal women became postmenopausal postoperatively. CONCLUSION(S): Laparoscopic bipolar coagulation of uterine vessels appears to be a promising new method for treating fibroid-related menorrhagia and pelvic pain.     

Laser miniconization - a new method of treating mild and moderate cervix dysplasia

The miniconization by carbon dioxid laser is a non-destructive method for treatment of mild and moderate dysplasia of the uterine cervix permitting an adequate histopathological interpretation of the whole transformation zone. The risk of postoperative haemorrhage is minimal which enables ambulant care. 413 patients have hitherto been treated and we have found carcinoma in situ in 16.7%, micro-invasive carcinoma in 1.2% and invasive carcinoma in 0.25%.