A New Nonfluoroscopic Navigation System to Guide Pulmonary Vein Isolation

Different techniques have been proposed to treat atrial fibrillation (AF) by catheter ablation. This study compares a new three-dimensional (3D) nonfluoroscopic navigation system with conventional fluoroscopy to guide pulmonary vein (PV) isolation. A total of 60 consecutive patients with paroxysmal or persistent AF were randomly assigned to 3D-guided ablation (group 1, n = 30), versus conventional fluoroscopy guidance ablation (group 2, n = 30). Complete PV isolation was achieved in both groups. The mean duration of fluoroscopy exposure (22 ± 8 vs 56 ± 10 minutes), and radiofrequency delivery (5 ± 1 vs 10 ± 3 minutes) were significantly shorter in group 1 than in group 2, P < 0.05 for both comparisons). The mean procedural time in group 1 was longer (225 ± 15 minutes) than in group 2 (156 ± 10 minutes, P < 0.05) due to the learning curve and time spent to generate the 3D maps. Over a mean follow-up of 7 ± 2 months, 6 patients (20%) in group 2 had AF recurrences compared to 3 patients (10%) in group 1 (ns). The new nonfluoroscopic 3D system allows a high-resolution reconstruction of the left atrium and PVs. It significantly reduces the mean radiofrequency delivery and fluoroscopy times as opposed to ablation performed under fluoroscopy guidance.     

Primary infertility in women exposed to diethylstilboestrol in utero

Summary. In a selected group of 40 women who had been exposed to diethylstilboestrol in utero , 18 conceived without difficulty and 22 had primary infertility. Among those with primary infertility there was a significantly higher rate of anatomical structural defects and a greater tendency for menstrual disorders than in those without infertility. Thirteen (59%) of the women with primary infertility conceived, most after treatment with ovulation stimulating drugs. Spontaneous abortion and tuba1 pregnancy were frequent (47% and 10% respectively) and similar in both fertility groups. Of 13 infertile women examined, 4 (31%) had mild hyperprolactinemia—a hithero unreported finding for such women.     

The Efficacy of Photodynamic Therapy in Actinic Cheilitis of the Lower Lip: A Prospective Study of 15 Patients

BACKGROUND Photodynamic therapy (PDT) has been developed into a widely used method to treat actinic keratoses and basal cell carcinoma.
OBJECTIVE The objective was to assess the efficacy of PDT in the treatment of actinic cheilitis of the lower lip.
METHODS In this prospective, uncontrolled study at a university dermatology department, 15 patients with actinic cheilitis received two sessions of PDT of the lower lip at an interval of 1 week using methylaminoxopentanoate and red light. Clinical and histopathologic evaluation was performed 3 months after therapy.
RESULTS Complete clinical cure was observed in 47% (7/15) and partial cure in another 47% (7/15) of the patients. By histopathologic analysis, residual disease was found in 62% (8/13). Cosmetic results and patients' satisfaction were good to excellent in most cases. Local pain was sufficiently controlled by local anesthesia.
CONCLUSION PDT can be an effective noninvasive method to treat actinic cheilitis of the lower lip.