Fertility Enhancing Hysteroscopic Surgery: Our Experience

690 hysteroscopies done over a period of four and a half years for infertility were evaluated. 85 therapeutic hysteroscopic procedures like hysterscopic metroplasty, lysis of intrauterine adhesions, electroresection of fibroids, removal of foreign bodies and cornual cannulation were carried out. These minimally invasive procedures were associated with satisfying results, least morbidity, shorter hospital stay and high patient satisfaction.Key Words: Cornual cannulation, Electroresection, Hysteroscopy, Intrauterine adhesions, Metroplasty, Submucus fibroids     

Creatinine clearance versus serum creatinine as a risk factor in cardiac surgery

Background  

Renal impairment is one of the predictors of mortality in cardiac surgery. Usually a binarized value of serum creatinine is used to assess the renal function in risk models. Creatinine clearance can be easily estimated by the Cockcroft and Gault equation from serum creatinine, gender, age and body weight. In this work we examine whether this estimation of the glomerular filtration rate can advantageously replace the serum creatinine in the EuroSCORE preoperative risk assessment.     

Clinical review of patients with fixed bridges (2). A study of deviations between observers

The authors have made a study of observer deviations in the re-examination of patients with fixed bridges. The material consisted of eighteen patients who have had their bridges for about 2 years. The total number of bridge-elements was 126, including eighty-three abutment teeth and forty-three politics. Nine observers have taken part. Of these, three have been teachers and six post-clinical students, so that it has been possible to say that the observers had more, and lesser, experience of routine observation. The recorded factors have been: (1) primary contact; (2) the general status of the marginal periodontium; (3) calculus; (4) caries; (5) periapical status; (6) attrition facet; (7) abrasion in the opposing jaw; (8) crown margin excess; (9) crown margin deficit; (10) exposed crown margin; (11) pocket formation; (12) discolouration of gold. The examinations have been carried out in a conventional milieu with the usual instruments for examination and with access to orthopantomograms. The recordings have been made after independent as well as cumulative and simultaneous examination. In the last two cases the observers have been divided into three groups. A very simple account of the results regarding the first five factors is given. It is quite clear, however, that the nine observers record different totals and that positive finds are at the same time seldom reported by all. Each of the seven remaining factors has given rise to a larger number of (positive) recordings, so that a more detailed processing has been meaningful. Within each factor (with a certain exception for abrasion) considerable deviations are found between the nine independent observers in the matter of totals. It has been possible with analysis of variance to confirm, to a great extent, these deviations as significantly systematic. In connection with the change to cumulative and simultaneous observer strategy it has been possible to note certain improvements. It has not, however, been possible to designate the agreement between the three observer groups as appreciable. On the other hand, the number of positive recordings increases most frequently in connection with the changes to (Cum) and still more with the change to (Sim). The nine observers change level in relation to one another on moving from the one factor to the other. Within a certain factor they sometimes vary also between different patients, though a certain logical pattern appears. Through comparisons in pairs and the calculation of the correlation (expressed through the coefficient r) it has been possible to show that the correlation between the recordings of two observers is not always satisfactory. However, the conventional limit + 0.70 is exceeded in the majority of cases. The two groups of observers do not differ characteristically from each other factor by factor, (the factors ‘general status of the periodontium’ and ‘crown margin excess’ constitute exceptions). Both teachers and students change position in an irregular way. Each one of the nine observers may occur alternately as a high and a low recorder. The authors recommend further studies in this field with the aim of throwing light upon the homogenization of observers and becoming better informed concerning the precise significance of utilizing different observer strategies.     

Caffeine and Pregnancy Outcome

Caffeine is a drug which easily crosses the placental barrier and enters the fetal circulation. To date, most studies that demonstrate caffeine's teratogenic potential have been conducted in animal models. Although no definite relationship in humans has been confirmed, it is suggested that a pregnant woman should limit or discontinue her intake of caffeine.     

Co57 Vitamin B12 Clearance Studies in Pernicious Anaemia

• 1 Clearance rate of intravenously administered radioactive vitamin B₁₂ in untreated pernicious anaemia patients is slow in 50 per cent of cases studied.
• 2 Administration of labelled vitamin B₁₂ bound to slow serum to ‘normal clearing’ pernicious anaemia subjects or to normal persons is followed by normal clearance rate.
• 3 Radioactive vitamin B₁₂ bound to normal serum is cleared at a normal rate in pernicious anaemia patients with slow clearance rate.
• 4 Radioactive vitamin B₁₂ bound to slow serum when mixed with normal serum in proportions of 1:1 or 1:0.5 is cleared at a normal rate in ‘slow clearing’ pernicious anaemia patients.
• 5 These studies suggest the presence of a ‘serum factor’ in normal serum and some patients with pernicious anaemia in relapse which enhances clearance of vitamin B₁₂ bound to ‘slow serum’.

     

A PROSPECTIVE STUDY ON THE INCIDENCE AND SIGNIFICANCE OF CONGENITAL CYTOMEGALOVIRUS INFECTION

Abstract. Screening of 3060 neonates for congenital cytomegalovirus (CMV) infection by virus excretion in the urine showed an overall incidence of 0.4%. The incidence was about 1 % for mothers between 16 and 25 years and only 0.2% for mothers between 25 and 35. No mothers over 35 years of age gave birth to congenitally infected infants. The percentage of women in the child-bearing age susceptible to CMV infection was estimated by the absence of CMV complement-fixing antibodies in cord sera and ranged from 48% to 33% with increasing age. None of the infected infants showed obvious signs of congenital CMV infection at birth. At follow-up, two infants showed slight, but transient symptoms compatible with a foetal infection; a pair of premature twins exhibited retarded physical and psychomotor development, but this could just as well be ascribed to the prematurity itself. None of the infants had detectable CMV-IgM antibodies in cord sera, but a trend towards elevated total IgM concentration in cord sera and elevated virus excretion titres appeared in the infants with symptoms. With the very low incidence and no signs of sensomotor sequelae the preliminary conclusion is that foetal CMV infection in our population by no means has a significance to deserve routine screening or a vaccination programme.     

Junctions between cells of the human enamel organ

abstract – Germs of primary teeth from the maxilla of two human fetuses were studied by electron microscopy. Cells of the stellate reticulum and stratum intermedium were found to be connected by desmosomes and by gap junctions. Some possible implications of the role of gap junctions are considered.