Clinical versus ultrasonographic evaluation of scrotal disorders

Clinical and ultrasonographic examinations of scrotal disorders were compared in 166 patients in order to determine their ability to distinguish between those diseases requiring surgery and those requiring clinical follow-up only. Ultrasound examinations were efficient in discriminating between normal and pathological findings. Extra-testicular lesions were readily differentiated from testicular ones. Although both clinical and ultrasonographic examinations had high sensitivity (90%) in detecting testicular cancer, the number of false positive findings was smaller after ultrasound examination. This gave a predictive value of a positive test of 53% after ultrasound examination but only 33% after clinical examination. Ultrasound examination may, therefore, reduce the number of surgical explorations in the scrotum and should be performed in patients with suspected testicular pathology based on history and palpatory findings.     

Recurrent hip dislocation in intermediate spinal atrophy

Recurrent hip dislocation after corrective orthopaedic surgery in children and teenagers with intermediate spinal atrophy has not been reported in the literature. Four cases with long-term follow-up are presented. These represent the only cases surgically treated in 30 years of following spinal atrophy patients. Thus, it seems significant that all hips redislocated after the surgical procedure. In addition, two patients had second operations with subsequent dislocation. Pelvic obliquity should not be the basis for the surgery, as spinal fusion is generally necessary for wheelchair users. The sagacity of performing surgery for hip dislocations is raised.     

腕管综合征主要症状体征敏感性与特异性的比较

目的　比较腕管综合征 (carpaltunnelsyndrome ,CTS)主要症状、体征的敏感性与特异性。方法　对 10 1例 ( 162只手 )进行症状严重程度与功能状况的询问 ,感觉、运动功能的检查 ;其中 62只手在术后 6周再次测定。结果　 162只患手中 15 8只具有典型症状 ( 98% )。Phalen征、前臂正中神经加压征、Semmes Weinstein单丝纤维测试阳性率分别为 98%、96%、82 %。 87%的患手出现肌力下降 ,拇短展肌肌力测定 (定量法 )结果显示 ,与徒手法相比 ,不同性别间、术前与术后的差异均具非常显著意义 (P <0 .0 1)。结论　典型症状、Phalen征、前臂正中神经加压征、拇短展肌肌力变化的敏感性与特异性最高 ,拇短展肌肌力定量法测定是判断腕管综合征严重程度、评定疗效的一个良好的客观指标。     

SADE database for endoscopic procedures: aspects of clinical use.

The time aspects of daily use of a clinical database system in an endoscopy department were studied. The SADE database system for endoscopic procedures was introduced for daily use at Ullev?l Hospital on 1 January 1989. The average weekly programme of the endoscopy unit includes 57 gastroduodenoscopies, 23 colonoscopies and 12 ERCP/EPTs. During three consecutive weeks of the study the mean physician input time was 4 min 17 sec per patient (range 57 sec to 15 min), individual variation depending mainly on the extent of the report. Assistants spent a mean time of 4 min 23 sec for each patient. Thus, a total of 8 min 40 sec was spent for every patient seen. Endoscopic units should analyze their routines and needs before introducing an electronic data base manager.     

Postabortal septic pelvic thrombophlebitis diagnosed with computed tomography. A case report

Septic pelvic thrombophlebitis is an uncommon complication in obstetrics and gynecology that may be difficult to diagnose clinically. Computed tomography (CT), an accurate and noninvasive modality, has greatly aided in the diagnosis of this disorder. In a case of septic pelvic thrombophlebitis complicating second-trimester pregnancy termination, CT enabled the correct diagnosis to be made and treatment to be initiated.     

Epidemiology of multiple sclerosis in the county of Vestfold, eastern Norway: incidence and prevalence calculations

The county of Vestfold in the South-eastern part of Norway has undergone two incidence and prevalence surveys on multiple sclerosis. The prevalence of definite/probable MS on January 1.1963 was 61.6/100000. Based on the same diagnostic criteria, the present study reports a slight increase in prevalence to 86.4/100000 on January 1st 1983. The average annual incidence was calculated for 5 years periods from 1953 to 1983. The time periods 1953–1962 and 1973–1977 showed age-adjusted incidence rates between 4.50 and 5.49/100000 while the 10–year period 1963–1972 showed significantly lower rates. The fluctuating pattern of MS incidence and prevalence over time supports the view that MS is not a stable disease, and that exogenous factors are influencing the disease pattern.